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DocuSign Envelope ID:6F1553FC-E9E6-4220-921 D-05CBF775BB94 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Shackelford&Associates Party/Vendor Contact Person: Matt Hawk Contact Phone: 252-215- <br /> 2250 Party/Vendor Address: 3750-A South Evans Street City Greenville State:NC Zip: 27834 Department: DEAPR <br /> Amount: $2,000 Purpose:Appraisal for conservation easement for Hill/Fickle Creek Land Company properties Budget <br /> Code(s): 61370035 850000 20006 Vendor#57220 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No <br /> ® Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date March 6, 2017 Approved by <br /> Board Yes❑No Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> DocuSigned by: <br /> Department Director's Signature Au- A.Atit Date: 3/6/2017 <br /> � 611CFA1D507A495... <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: �1.1�. <br /> Office of the Risk Management Officer <br /> ((USX((USX (b""A,d6 Date: 3/7/2017 <br /> �---7FDCF9178800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Officer (21.4-4 An Date: 3/22/2017 <br /> � 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorney jO(un, VO1t Date: 3/23/2017 <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 2/17 5 <br />