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DocuSign Envelope ID: 3BA3A4EC-ODD2-41B2-A35A-6D989822C204 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Nice & Green Flooring Solutions, LLC Party/Vendor Contact Person: Chris Weske Contact <br /> Phone: 336-270-6551 Party/Vendor Address: 3254 S Anthony Court City Burlington State: NC Zip: 27215 <br /> Department: AMS for Depatment on Aging Amount: $2095 Purpose: Upholstery and Carpet Clearing at Passmore & <br /> Sol s Gray Floreance Day Health Program Centers Budget Code(s): 10240520-630000 Vendor#60940 (N/A if new <br /> vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ® Renewal ❑ <br /> Amendment ❑ Effective Date 09/22/2016 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to technical form &del? P d*by: <br /> Department Director's Signature 7 Date: 9/16/2016 <br /> 9E880A46CF64498... <br /> Information Technolosies <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 /> Docu5igned��,by: 11i1 <br /> Office of the Risk Management Officer Pausa, ('6 6 Date: 9/16/2016 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> DocuSig ed by: <br /> Office of the Chief Financial Officer rl �°n.�l Date: 9/16/2016 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal to II'M€kow�y: <br /> ,�66, r6 9/16/2016 <br /> Office of the County Attorney Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloy(d c�orangecount.plc.gov <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> Office of the Clerk to the Board Date: <br /> Revised 6/16 5 <br />