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DocuSign Envelope ID: F08286FF-FCF5-48EB-9A5B-EF6048EEA541 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: 5th Wall Building Diagnostics Consultants Party/Vendor Contact Person: Jeff Spady Contact <br /> Phone: 919-616-4715 Party/Vendor Address: 9601 Baileywick Rd City Raleigh State: NC Zip: 27615 Depai l,nent: <br /> AMS Amount: $1,250.00 Purpose: FACADE COND. EAC Budget Code(s): 10240320-630000 Vendor # 58369 <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New ❑ Renewal <br /> ❑ Amendment ❑ Effective Date 01/03/2017 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> r—DOCUSignetl by. <br /> Department Director's Signature 2 E"e" Date: 1/13/2017 <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 /> r—DOCUSignetl by: <br /> Office of the Risk Management Officer Q(sa Co ' Date: 1/13/2017 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> r—DOCUSignetl by. <br /> Office of the Chief Financial Officer (1.N " Date: 1/17/2017 <br /> L-7D4E5101ACC1400.. <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> crt <br /> �—DOOsigetl by: <br /> Office of the County Attorney 0 rOys Date: 1/18/2017 <br /> �tA„D3tDUAb466 <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd(aliorangecountync.gov 1, <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 1/16 4 <br />