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DocuSign Envelope ID: 78EE5ED3-1EEE-40CF-A7C1-433DD817F9AF <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Civil Consultants Party/Vendor Contact Person: Tony Whitaker Contact Phone: <br /> 919.490.1645 Party/Vendor Address: 3708 Lyckan Parkway Ste 201 City Durham State: NC Zip: 27707 <br /> Department: AMS Amount: $7,500.00 Purpose: Consulting Engineering Services for Property investigation of <br /> Parcel 9865685784 Coleman Loop Budget Code(s): 61370035-870000-10020($3,750)& 61370035-870000-10051 <br /> ($3,750) total $7,500 Vendor # 62089 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No <br /> Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 10/30/17 Approved by Board <br /> Yes No Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> Department Director's Signature[q °"'p"°"' Date:10/18/2017 <br /> �aEaeoA4�F64�a <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 /> Office of the Risk Management Office a(asa Date: 10/18/2017 <br /> 7F.F9176800498 <br /> Financial Services <br /> r. This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: <br /> Office of the Chief Financial Officer 21-21— Date:10/19/2017 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> aed ev: <br /> Office of the County Attorney ,�eG n reti`v s Date: 10/20/2017 <br /> � <br /> �,,,133raAa465_ <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 />