R 2017-053-E AMS - Triangle Landscaping, Inc. for Homestead Road Sidewalk Storm Drain Repairs

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DocuSign Envelope ID: FBBAAB56-EF88-48BC-8A7D-E897492F5CCB ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Triangle Landscaping,Inc./trianglelandscapemgmt @gmail.com Party/Vendor Contact Person: Brad Lewis Contact Phone: 919-730-5267 Party/Vendor Address: PO Box 144 City Stem State: North Carolina Zip: 27581 Department: AMS Amount: NTE$3,500.00 Purpose: Homestead Road Sidewalk Storm Drain Repairs Budget Code(s): 61370035-880000-10052 Vendor# 62218 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 1/25/17 Approved by Board Yes❑No Agenda Date: This agreement is approved as to technical form and content: D Sg tlby Department Director's Signature 241 °°"P Date: 1/24/2017 Information Technologies (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: r—DOCUSignetl by: Office of the Risk Management Officer a(sa C°wu}Io Date: 1/26/2017 Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: D Sg tlby. Office of the Chief Financial Officer1 Date: 2/2/2017 7o4e5181ACC140e_. Legal Services This agreement is approved as to legal form and sufficiency: �—DOOsigetl by: Office of the County Attorney 'i0tA" ros Date: 2/6/2017 �—ennaoaseoanaaes_e Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Revised 6/16 5