Orange County NC Website
DocuSign Envelope ID: E271A49A-1BD2-4431-90DF-FC9C4F52CE69 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Riley Surveying,P.A. Party/Vendor Contact Person: Phillip Riley(philr @rileysurveyingpa.com) <br /> Contact Phone: 919.667.0742 Party/Vendor Address: 3326 Durham Chapel Hill Blvd. Ste B-100 City Durham State: <br /> NC Zip: 27707 Department: AMS Amount: $8,750.00 Purpose: Topographic Survey of the Whitted Complex <br /> Budget Code(s): 61370035-870000-30001 Vendor # 52775 (N/A if new vendor) Vendor is a BOCC consultant? <br /> Yes ❑ No Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 5/25/2017 <br /> Approved by Board Yes❑No Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> o sg y <br /> fly 7 paw 5/30/2017 <br /> Department Director's Signature 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 /> o sg aey <br /> Q(asa <br /> (01W-to 5/31/2017 <br /> Office of the Risk Management Office z„,,,F„,„ Date: <br /> Financial Services <br /> '7," This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> rq <br /> �—oos�gea ey: <br /> Office of the Chief Financial Officer 6/1/2017 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> �—oos�gea ey: <br /> Office of the County Attorney_0�„. �otiwts Date: 6/1/2017 <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 />