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DocuSign Envelope ID:8A89E5D4-F8B5-49AF-8D96-4FABAAC6420A <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Riley Surveying, P.A. Party/Vendor Contact Person: Phillip W. Riley <br /> (philr @rileysurveyingpa.com) Contact Phone: 919-667-0742 Party/Vendor Address: 3326 Durham Chapel HIll Blvd., <br /> Suite B-100 City Durham State: North Carolina Zip: 27707 Department: AMS Amount: $9,400.00 Purpose: <br /> Surveying services for Old Courthouse and Jail Budget Code(s): 61370035-870000-10051 Vendor# 52775 (N/A if <br /> new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ® Renewal ❑ <br /> Amendment ❑ Effective Date 1/25/17 Approved by Board Yes❑No Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> r—DOCUSignetl by. <br /> 1/22/2017 <br /> Department Directors Si nature 2r «< , Date: <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 /> Aisa CovtAdo 1/24/2017 <br /> Office of the Risk Management Officer, <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> �� DocuSignetl by. <br /> 5/17/2017 <br /> Office of the Chief Financial Office rEl°'N °" °" Date: <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Doosigetl by: <br /> Office of the County Attorney )06 �0�` Date: 5/17/2017 <br /> EDHA3465... <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 />