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DocuSign Envelope ID:6EED282B-AE99-4E23-8F12-8D5CFC79F06D <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: ASD(Asphalt Services On Demand) Party/Vendor Contact Person: Tim O'Donnell (tim.o e,asdinc.net) <br /> Contact Phone: 919.524.1979 Party/Vendor Address: 959 Short Journey City Smithfield State: NC Zip: 27577 <br /> Department: AMS Amount: NTE$100,702.50 Purpose: Skills Development Repave Parking Lot Budget Code(s): 61370035- <br /> 880000-30029 Vendor#N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check <br /> one)New® Renewal ❑ Amendment ❑ Effective Date October 20,2016 Approved by Board Yes❑No® Agenda <br /> Date: <br /> This agreement is approved as to technical form and content: <br /> 05 bow <br /> Department Director's Signature EE�� Date: 10/18/2016 <br /> Information Technologies <br /> i <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is approved as to <br /> 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 /> Uoc 59 dby: <br /> Office of the Risk Management Office QUsa(,awu b Date: 10/19/2016 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> Uoc 59 dby: <br /> Office of the Chief Financial Officer Date: 10/24/2016 <br /> 1 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> U 5'9 d by. <br /> Office of the County Attorney �66°r6uw s Date: 10/25/2016 <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydgoran eg_countmc.gov <br /> i <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 /> C <br /> Revised 6/16 10 <br />