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DocuSign Envelope ID:8ACECC22-FA6C-4199-B37B-E8B08A81BA4E <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Pickard Roofing Company Inc Party/Vendor Contact Person: Frank Meunier <br /> (frank&pickardroofing.com) Contact Phone: 919-682-5702 Party/Vendor Address: 823 East Trinity City <br /> Durham State: NC Zip: 27702 Department: AMS Amount: 1450.00 Purpose: Remove Gutters for Fascia board <br /> repairs Budget Code(s): 61370035-882000-30002 Vendor # 63750 (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes ❑ No[] Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date <br /> December 5,2016 Approved by Board Yes❑No® Agenda Date: <br /> This agreement is approved as to technical forth and content: <br /> D Sg tlby. <br /> Department Director's Signature "� Date: 12/1/2016 <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 /> D s",tlby. <br /> Office of the Risk Management Officery�`sa� 'y I Date: 12/1/2016 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: <br /> D ­­d <br /> Office of the Chief Financial Officer��"� �°'"�°" Date: <br /> 12/1/2016 <br /> 7D E5181ACC1409_. <br /> Legal Services <br /> This agreement is approved as to legal forth and sufficiency: <br /> D S tlby. <br /> Office of the County Attorney �0�` Date: 12/1/2016 <br /> P-1111t1-115_ <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.plc.gov <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> Revised 6/16 6 <br />