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DocuSign Envelope ID:93098A2A-6990-46FE-8E24-D3170617D942 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Hillsborough Plumbing Company Inc. Party/Vendor Contact Person: Rob McKee Contact <br /> Phone: 919-732-4506 Party/Vendor Address: 1020 Highway 57 N. City Hillsborough State: NC Zip: 27278 <br /> Department: Planning Amount: $4,575.00 Purpose: Install RPZ at Brookhollow Pump Station in the Efland Sewer <br /> System Budget Code(s): 51360120-571000 Vendor#58196 (N/A if new vendor) Vendor is a BOCC consultant? <br /> Yes ❑ No Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 5/17/2017 <br /> Approved by Board Yes No Agenda Date: <br /> This agreement is approved as to techntidarggtond content: <br /> Department Director's Signatur Ci0 6j1 Date: <br /> 846D1ODA3CFD4C2... <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 /> Office of the Risk Management Office ESA C,bvtAh 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 Office 0ona,ZIm <br /> a Date: <br /> 7D4E5181 ACC1409... <br /> Legal Services <br /> This agreement is approved as to lenal form and sufficiency: <br /> ocuSigned by: <br /> Office of the County Attorne ib rblitXtS 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 @ 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 />