R 2016-686-E AMS - 5th Wall Building Diagnostic Consultants for roof repairs

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DocuSign Envelope ID:8D5C8D49-CCF8-47B1-A64E-FB45BC812ED4 ORANGE COUNTY-DEPARTMENT USE ONLY Department Party/Vendor Name: 51' Wall Building Diagnostic Consultants Party/Vendor Contact Person: Jeff Spady (5thwall&bellsouth.net) Contact Phone: 919.616.4715 Party/Vendor Address: 9601 Baileywick Road City Raleigh State: NC Zip: 27615 Department: AMS Amount: $2150.00 Purpose: Roof repairs Budget Code(s): 61370035- 880000-30002 Vendor# 58369 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 11/29/16 Approved by Board Yes❑ No[] Agenda Date: This agreement is approved as to technical form and content: 7z4 yaw Department Director's Signature Date: 12/1/2016 Information Technolosies (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer Date: Risk Management This agreement is approved for sufficiency of insurance standards, specifications,and requirements: oo sg aey Office of the Risk Management Office gusa C,owu b Date: 12/2/2016 Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: d ey: Office of the Chief Financial Officer � a_ Date: 12/2/2016 Legal Services This agreement is approved as to legal form and sufficiency: o sg aey: �o(un Office of the County Attorney r6 S Date: 12/2/2016 Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloy(d c�orangecount.nic.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board Date: Revised 6/16 5