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DocuSign Envelope ID:05BAC521-A573-4502-9361-CAFO7F6BEC40 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Roof Control Services of North Carolina, Inc Party/Vendor Contact Person: Brian Burns <br /> (bbums @roofcontrol.com) Contact Phone: 919.441.7668 Party/Vendor Address: 104 Rand Park Drive City Garner <br /> State: NC Zip: 27529 Department: AMS Amount: 3,410.00 Purpose: Install waterproofing to the chimney and <br /> existing wall of the District Attorney Building to stop water infiltration into the facility Budget Code(s): 61370035- <br /> 882000-30002 Vendor# 64465 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract <br /> Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date June 30,2017 Approved by Board Yes <br /> ❑No® Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> o sg y <br /> Department Director's Signature 2 7 "'°" Date: 6/29/2017 <br /> Asset Management <br /> (Applicable only to construction contracts)This agreement has been reviewed and is approved as to construction <br /> services content and specifications: <br /> o sg y <br /> paw 6/29/2017 <br /> Office of the Asset Management Directo fl 2 y Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards, specifications,and requirements: <br /> �—oos�gea ey: <br /> Office of the Risk Management Officer,_,, (01W-to Date: 7/3/2017 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> 06 Act: <br /> Office of the Chief Financial Officer '6°'" °" Date: 7/5/2017 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> oos�gea ey: <br /> o,)LA,roknts 7/7/2017 <br /> Office of the County Attorney Date: <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 /> Revised 2/17 6 <br />