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DocuSign Envelope ID: B6F716CE-0006-4D10-9BB0-5E5E16EFC339 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: 5th Wall Building Diagnostics Party/Vendor Contact Person: Jeff Spady <br /> (jeff @5thwallbdc.com) Contact Phone: 919.616.4715 Party/Vendor Address: 9601 Baileywick Rd City Raleigh <br /> State: NC Zip: 27615 Department: AMS Amount: $1.600.00 Purpose: Provide oversite of construction work at <br /> the CGCC North Wing waterproofing and drain installation Budget Code(s): 61370035-880000-10016 Vendor # <br /> 58369 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one)New <br /> Renewal ❑ Amendment ❑ Effective Date 6/28/2017 Approved by Board Yes❑ No Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> o sg y <br /> fly paw 6/29/2017 <br /> Department Director's Signature H�®�,,y��� . 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 /> Office of the Risk Management Office aGsa C611"".ffo Date: 7/3/2017 <br /> �,�o�7a�aa.Qa_ <br /> Financial Services <br /> ,s This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> 06 Act: <br /> �—oos�gea ey: <br /> Office of the Chief Financial Officer " a, Date: 7/5/2017 <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� �Ohw{s Date: 7/7/2017 <br /> tY Y,�t,����„._ <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 <br /> 9 <br />