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DocuSign Envelope ID:A9CF8A9E-4CDB-4BB9-A678-D4AD80CD1393 <br /> ORANGE COUNTY-DEPARTMENT USE_ONLY <br /> Department <br /> Party/Vendor Name: Baker Roofing Party/Vendor Contact Person; Dylan Baker Contact Phone: 919.828.2975 Party/Vendor <br /> Address: 517 Mercury Street City Ralei State: NC Zip: 27603 Department: AMS Amount: 170,320 Purpose: Replace <br /> Central Recreation Building Roof Budget Code(s): 61370035-880000-30002 Vendor#56403 (N/A if new vendor) Vendor <br /> is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New ® Renewal <br /> ❑ Amendment ❑ Effective Date <br /> 11/7/16 Approved by Board Yes❑No® Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> D Sg dby <br /> Department Director's Signature �°"�°°" Date: 11/15/2016 <br /> E� gg <br /> Information Technologies <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 /> D Sg dby. 11/16/2016 <br /> Office of the Risk Management Office Q- �ewu f{o Date: <br /> 7MUr977F, N08.:::.. <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> Doc s g a by <br /> Office of the Chief Financial Officer Date; 11/16/2016 . <br /> 3 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> D S g dby: <br /> Office of the County Attorne ,i, Date: 11/16/2016 <br /> �F.AA3D33F.D6A8465... <br /> Clerk to the Board <br /> Received for record retention; <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@oran e� countync. og_v <br /> The following signature block is Tor hard copies only and is not required for Docusign contracts: <br /> Office of the Clerk to the Board Date: <br /> Revised 6/16 10 <br />