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DocuSign Envelope ID: BAA7622D-F739-4FEB-B14B-B159D1AAFE25 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Gonzalez Painters & Contractors INC Party/Vendor Contact Person: Javier Gonzalez Contact <br /> Phone: 919-619-8041 Party/Vendor Address: 4301 Bennett Memorial Rd City Durham State: NC Zip: 27705 <br /> Department: AMS Amount: $1,900.00 Purpose: Norwood Law Painting Budget Code(s): 10240320-570000 Vendor <br /> # 61921 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one)New❑ <br /> Renewal❑ Amendment ❑ Effective Date 10/21/2016 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> uSigned by: <br /> Department Director's Signature Fi; O'"y'�O"� Date: 10/18/2016 <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 /> DocuSigned by: <br /> ''1111 <br /> Office of the Risk Management Officer <br /> FaUSX r,6ntt�16 Date: 10/19/2016 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner,gn9yged by the Local Government Budget and Fiscal Control Act: <br /> DocuSign y: <br /> Office of the Chief Financial Officer Date: 10/19/2016 <br /> (� s�oraR,�losz <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> uSigned by: <br /> r6 v s 10/19/2016 <br /> Office of the County Attorney 56Z, Date: <br /> EAAMKEDM8465... <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.nic.Rov <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 />