R 2017-202-E AMS - Chatham Electric Service to provide, install power for EV charging station at Seymour Center

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DocuSign Envelope ID: 5EF6EC93-A3D2-4E5A-9344-B85C5B99409C ORANGE COUNTY-DEPARTMENT USE ONLY Department Party/Vendor Name: Chatham Electric Service Party/Vendor Contact Person: Joel Bulpitt (joel @chatham- electric.com) Contact Phone: 919.896.4302 Party/Vendor Address: 145 Ryan Road City Pittsboro State: NC Zip: 27312 Department: AMS Amount: $2.800.00 Purpose: Provide and install power for EV charging station at the Seymour Center Budget Code(s): 10240020-680090 (Duke Energy EV Grant) Vendor # 64501 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 5/25/17 Approved by Board Yes' No Agenda Date: This agreement is approved as to technical form and content: o sg y Department Director's Signature 2 74 '"'°" Date: 5/30/2017 Asset Management (Applicable only to construction contracts)This agreement has been reviewed and is approved as to construction services content and specifications: o sg y Office of the Asset Management Directo 24/24:27: Date: 5/30/2017 Risk Management This agreement is approved for sufficiency of insurance standards, specifications,and requirements: �—oos�gea ey: Office of the Risk Management Officer a(as_�6 ` 0 Date: 5/31/2017 Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: �—oos�gea ey: Office of the Chief Financial Officer (.1'61 Date: 6/1/2017 Legal Services This agreement is approved as to legal form and sufficiency: o sg aey: CotuA,roknts 6/1/2017 Office of the County Attorney Date: Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Revised 2/17 6