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DocuSign Envelope ID:AAB48FBD-7E41-49ED-AF28-FCE317917B07 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Pickard Roofing Company Inc Party/Vendor Contact Person: Frank Meunier <br /> (frank a,pickardroofing com) Contact Phone: 919.682.5702 Party/Vendor Address: 823 East Trinity Ave City Hillsborough <br /> State:NC Zip: 27702 Department: AMS Amount: $53,460.77 Purpose: Gutter Replacement at Historic Courthouse Budget <br /> Code(s): 61370035-882000-30002 Vendor# 63750 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® <br /> Contract Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date 11/11/16 Approved by Board Yes❑No <br /> ® Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> U�o<Sf g <br /> n <br /> Department Director's Signature Date: 11/15/2016 <br /> �S6AT6L1 UTi_ <br /> Information Technologies � <br /> (Applicable only to hardware/sofhvare 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 /> U cu59 dby <br /> Office of the Risk Management Office Q(asa(awuflo Date: 11/28/2016 <br /> � � <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> U 5'9 dby <br /> Office of the Chief Financial Officer Date: 11/28/2016 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> g <br /> Office of the County Attorney �6 "'r6u" s Date: 11/28/2016 <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@oran eg coun nc.gov <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> k <br /> Office of the Clerk to the Board Date: <br /> Revised 6/16 10 <br />