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DocuSign Envelope ID:9E55035C-1051-4EBF-969E-3E6A4F06E2D5 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Kirkland Appraisals, LLC Party/Vendor Contact Person: Richard C. Kirkland, Jr. Contact <br /> Phone: 919-414-8142 Party/Vendor Address: 9408 Northfield Court City Raleigh State: NC Zip: 27603 Department: <br /> DEAPR Amount: $1,800 Purpose: A conservation easement appraisal of the Persimmon Hill Farm in Cedar Grove <br /> Budget Code(s): 61370035 850000 20006 Vendor#51941 (N/A if new vendor) Vendor is a BOCC consultant? Yes <br /> ❑ <br /> No Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date November 21, 2016 <br /> Approved by Board Yes No Agenda Date:December 5,2016 <br /> This agreement is approved as to technical form and content: <br /> r---DocuSigned by: <br /> Department Director's Signature V Sfawut Date: <br /> '-61 1 CFA1 D507A495... <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----DocuSigned""by: <br /> ''��.. <br /> Office of the Risk Management Officer gust, Cbvv, Date: <br /> `'*• 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required bsygt debLocal Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer [� ' °" Date:-7D4E5181 ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> �^---docuSigned by: <br /> Office of the County Attorney jbLln, Okts Date: <br /> �—EAA3D33ED8A8465... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydgorangecountync.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 />