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-571 <br /> ORANGE ORANGE COUNTY---DEPARTMENT USE ONLY---HARD COPY ONLY <br /> Department <br /> C I <br /> Dept. Contact: OPT Peter Murphy 245-2002 c„ j <br /> A <br /> t0 � t n Q�cou�- <br /> Party/Vendor Name: NCDOT/PTD Party/Vendor Contact Person: IM It—ema n Contact Phone: 919 707-464 <br /> Party/Vendor Address: 1550 Mail Service Center City Raleigh State: NC Zip: 27699-1550 Department: OPT ll1� S <br /> Amou ose: FY2017 Grant Agreement CTP Capital Budget Codes .4350-30-00-802000�eNew[4 endor# <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Con ct Type: (Check on n 7 <br /> Renewal❑ Amendment ❑ Effective Date 7/1/16 Approved by Board Yes®No❑ Agenda Date: 1115115 <br /> a <br /> This agreement is approved as to technical form and content: <br /> Department Director's Signature Date:71411� <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 /> ",*r <br /> Office of Risk Management lam — C�'p� Date: ` l <br /> Financial Services <br /> This instrument has been pre-audited in the er re re by t Local Government Budget and Fiscal Control <br /> Act: <br /> Office of the Chief Financial Officer Date: L <br /> Legal Services <br /> This agreement is approved as to legal form nd ffici <br /> Office of the County Attorney Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> t <br /> Office of the Clerk to the Board Date: _ <br /> Revised 6/16 <br />