R 2017-352-E AMS - Statler Gilfillen Architect - Amendment to Contract - upgrade restrooms at OC facilities

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DocuSign Envelope ID:4B735B44-FDA3-43D4-9F8F-3EDC4F31661 B ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Statler Gilfillen Architect Party/Vendor Contact Person: Statler Gilfillen Contact Phone:919.732.6123 Party/Vendor Address: 3302 St.Mary's Road City Hillsborough State:NC Zip:27278 Department:AMS Amount:225.00 Purpose:Increase existing contract for structural engineering services to add additional support header at the Rogers Road Community Center for the new restroom door to be installed Budget Code(s): 61370035-880000-30001 Vendor#63294 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No Contract Type:(Check one)New❑ Renewal❑ Amendment ® Effective Date 7/17/17 Approved by Board Yes❑No Agenda Date: This agreement is approved as to technical form and content: Department Director's Signature '94 77"--1-- Date: 8/1/2017 Asset Management (Applicable only to construction contracts)This agreement has been reviewed and is approved as to construction services content and specifications: Office of the Asset Management Directory '" Date: 8/1/2017 Risk Management This agreement is approved for sufficiency of insurance standards,specifications,and requirements: Office of the Risk Management Offices 7dN, Date: 8/1/2017 Financial Services '76 This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer( Date: 8/1/2017 Legal Services This agreement is approved as to legal form and sufficiency: )OL "YO' 8/1/2017 Office of the County Attorney , ra,,, 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: Office of the Clerk to the Board Date: Revised 2/17