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DocuSign Envelope ID: CEBE392A-5867-4D11-B672-64E40DB4322F <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Triangle Landscaping Inc Party/Vendor Contact Person: Brad Lewis <br /> (h•ianglelandscapemgmt n,gmail.com) Contact Phone: 919.730.5367 Party/Vendor Address: PO Box 144 City <br /> Stem State: NC Zip: 27581 Department: AMS Amount: 1350.00 Purpose: Water Valve Box extensions and <br /> concrete donute rings Budget Code(s): 61370035-880000-10052 Vendor# 62218 (N/A if new vendor) Vendor <br /> is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ <br /> Effective Date 11/21/16 Approved by Board Yes❑No® Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> D Sg tlby. <br /> Department Director's Signature °°fi"°" Date: 12/1/2016 <br /> �sea¢onaecFeaasa_. <br /> Information Technologies <br /> (Applicable only to hardtinare/sofAvare 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 Sg tlby: <br /> Office of the Risk Management Office &OL Date: 12/2/2016 <br /> ��eers icea¢asa.. <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 Sg tlby. <br /> � n <br /> Office of the Chief Financial Officer "� Date: 12/2/2016 � <br /> veaes�e ir,.,e ia¢s... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> D 5g tlby. <br /> Office of the Count Attorney �0L, rO�ts Date: 12/2/2016 <br /> Y Y� o <br /> —ennaoa¢eoanaass_ <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd cr oran_ecoun• nc.gov <br /> i <br /> r <br /> The following signature block is for hard copies only and is not required for Docusign contacts: <br /> Revised 6/16 5 <br />