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DocuSign Envelope ID:51F879E8-7702-4D23-B2F8-FA67BE720A84 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Palmer Generator Party/Vendor Contact Person: Todd Palmer Contact Phone: 336-270-4824 <br /> Party/Vendor Address: 3673 Alamance Road City Burlington State: NC Zip: 27215 Department: Planning Amount: <br /> $1,974.08 Purpose: Replace and install new genteraor controller,program and transfer switch at the Brookhollow Pump <br /> Station in the Efland Sewer System Budget Code(s): 51360120-571000 Vendor # 64558 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ <br /> Effective Date 6/23/17 Approved by Board Yes No Agenda Date: <br /> This agreement is approved as to techn,iaffa ,pd content: <br /> Department Director's SignatureCrai pp 0 1/ a1 Date6/21/2017 <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 sufficient gasve standards,specifications, and requirements: <br /> Office of the Risk Management Offic r USA CortAkftb Date: 6/22/2017 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited i epquired by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Office (1' 4441'6""1" Date: 6/22/2017 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to le^gg q a vd sufficiency: <br /> Office of the County Attorne b�t,IA, hatit-rtS Date: 6/22/2017 <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 />