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ORANGE COUNTY-DEPARTMENT USE ONLY C)/ <br /> Department <br /> Party/Vendor Name: Creekside Farm Party/Vendor Contact Person: Dwight Compton Contact Phone: 919-732-8487 <br /> Party/Vendor Address: 5900 Compton Rd City Cedar Grove State: NC Zip: 27231 Department: Plannine Amount: <br /> $1,000 Purpose: Mowing at Lake Orange Sediment Structures Budget Code(s): 10695020-720013 Vendor #-53-91$t 1039(P 1 <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New ® Renewal <br /> ❑ Amendment ❑ Effective Date 7/11/2016 Approved by Board Yes❑No® Agenda Date: <br /> This agreement is approved as to techni�fopx.and c �* <br /> Department Director's Signature <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> Office of the Risk Management Officer _p &,ems— Date: A& <br /> Mquiret <br /> This instrument has been pre-audited in the maGovernment Budge t d iscal Control Act: <br /> Office of the Chief Financial Officer Date: <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Office of the County Attorney '41.,W���l A,74,; Date: ci /$ (U <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon ompletion@Dolloyd@orangecountync.gov <br /> The following signature block is for hard copies t required for Docusign contracts: (� <br /> Office of the Clerk to the Board Date: ` <br /> Revised 10/14 4 <br />