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DocuSign Envelope ID:5714C130-71 CA-425F-9F66-AEAE54361068 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Landmark Surveying,Inc Party/Vendor Contact Person: Doug Yarbrough Contact Phone: 336- <br /> 229-6275 Party/Vendor Address: 109 East Harden Street City Graham State: NC Zip: 27253 Department: DEAPR <br /> Amount: $3,475 Purpose: To provide land survey services necessary to produce a recordable plat for the Lick Creek <br /> (Gledhill) conservation easeament Budget Code(s): 61370035 850000 20006 Vendor#44120 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ <br /> Effective Date March 22,2017 Approved by Board Yes No Agenda Date: December 13,2016 <br /> This agreement is approved as to technical form and content: <br /> r---DocuSigned by: <br /> Department Director's Signature V&A, S fetlA.Ut Date: <br /> "-61 1 CFA1 D507A495... <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----DocuSigned""by: <br /> '' .. <br /> Office of the Risk Management Officer gust, cortA ��t Date: <br /> `'*• 7FDCF9176800498... <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 Date:-7D4E5181 ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> r^ ocuSigned by: <br /> Office of the County Attorney jbLln, rolvts Date: <br /> `—EAA3D33ED8A8465... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydgorangecountync.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 />