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DocuSign Envelope ID:595F86A3-E7A8-4291-9C8B-CD13A314E128 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: American industrial Contractors, Inc. Party/Vendor Contact Person: Tommy Oliver Contact <br /> Phone: (336) 855-3301 Party/Vendor Address: PO Box 16224/2616 Phoenix Drive (27406) City Greensboro State: <br /> NC Zip: 27416-6224 Department: Solid Waste Amount: 2,505 Purpose: Heat and Air Service and Maintenance <br /> Budget Code(s): 50350020-570000 Vendor ff 59312 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ <br /> No® Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date October 1, 2016 Approved <br /> by Board Yes❑No® Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> Fi;��uSigned by: <br /> Department Director's Signature mtko" Date: 10/11/2016 <br /> 6E763F604A144E2... <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 /> PUS&DocuSigned"by:'�.Office of the Risk Management Officer (,bv>tic,11 b Date: 10/11/2016 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner%quired b�the Local Government Budget and Fiscal Control Act: <br /> o uSigned <br /> Office of the Chief Financial Officer 0.&. Date: 10/12/2016 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorney Jb L°b�c v�5 Date: 10/12/2016 <br /> EAAMKEDM8465... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dollo d&oran etync.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 />