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DocuSign Envelope ID:9AA5E326-97D5-4361-B4DA-516EAE150E42 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: CST Fleet Services Party/Vendor Contact Person: Ron Hall Contact Phone: 336-287-8348 <br /> Party/Vendor Address: 1325 Central Road City Clemmons State: NC Zip: 27012 Department: AMS Amount: NTE <br /> 51000 Purpose: Post Chargeback Study and Fleet Efficiency Activities Budget Code(s): 10240420-630000 Vendor# <br /> 63690 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ <br /> Renewal❑ Amendment ® Effective Date 12/02/2016 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to technical fort�L�Joa/ng�'oAt�e,. <br /> Department Director's Signature nt: <br /> d 6; o jxo° Date: 12/1/2016 <br /> "' <br /> 9E880A46CF64498... <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 /> Docu5igned��,by: 11i1 <br /> Office of the Risk Management Officer Pausa, ('6 6 Date: 12/3/2016 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the mannerjroe g�j�bby the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer °'�"��°'v Date: 12/5/2016 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and s4�j� &dyuy: <br /> Office of the County Attorney 56,�6, rb�� Date: 12/5/2016 <br /> AA3D33ED8A8465... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dollod(cr�,oran eg countvnc og_v <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 4 <br />