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DocuSign Envelope ID:9E1 F9021-C474-4807-8F93-1 C616BEBDEF1 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: BIRS, Inc Party/Vendor Contact Person: Levi Brocker (levi.broeker @yahoo.com) Contact <br /> Phone: 336.574.3060 PartyNendor Address: 207 Robbins St. City Greensboro State: NC Zip: 27416 9[,S <br /> Department: AMS Amount: 10,357.00 Purpose: Whitted Building A & B Flashing Repairs Budget Code(s): <br /> 61370035-882000-30002 Vendor# 57369 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® <br /> Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 10/23/17 Approved by Board <br /> Yes' No Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> Docusigned by: <br /> Department Director's SignatureE °r °' Date: 10/15/2017 <br /> .880A460F64498... <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 /> �--DOCUSigned by: <br /> Office of the Asset Management Director S' p°°" Date:10/15/2017 <br /> •-9F880A46(.F64498... <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> �DOOsgoea by: <br /> Office of the Risk Management Officer a tsL(aka Date: 10/16/2017 <br /> �]FDCF91]6800498... <br /> Financial Services <br /> D6 This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> 06' <br /> Act: <br /> i—DOCsigea by: <br /> Office of the Chief Financial Officer (A-161 Date:10/17/2017 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> �--DxuSignetl by: <br /> Office of the County Attorney i"41°wts Date:10/18/2017 <br /> FAA3D33FD6A8465... <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 />