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DocuSign Envelope ID: 5084246A-7988-4068-804E-9127EAD179DB <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Nice & Green Flooring Solutions, LLC Party/Vendor Contact Person: Chris Weske, Owner <br /> Contact Phone: 336-404-9197 Party/Vendor Address: 1183 University Dr. #105-113 City Burlington State: NC Zip: <br /> 27215 Department: AMS Amount: $13,450.20 Purpose: Flooring restoration - north side county facilities Budget <br /> Code(s): 10240520-630000 Vendor# 60940 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ <br /> Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 01/03/2017 Approved by Board <br /> Yes❑No❑ Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> • DocuSigned by: <br /> Department Director's Signature P.# �O"`7�'�°"' Date: 12/28/2016 <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 /> • DocuSigned""by: <br /> ''11i1 <br /> Office of the Risk Management Officer aLSo (OMA-li 4 Date: 1/17/2017 <br /> � 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the ma' osrsaiyed by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer ` ru.4°'v Date: 1/23/2017 <br /> � 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> • DocuSigned by:�,,L, <br /> Office of the County Attorney ,W0n VO1u'l S Date: 1/24/2017 <br /> ` EAA3D33ED8A8465... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecountync.gov <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 5 <br />