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DocuSign Envelope ID:OFEF1983-CF97-41 B4-A62D-85E8210991 DF <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: David Hinkle Party/Vendor Contact Person: David Hinkle Contact Phone: 919-270-4277 <br /> Party/Vendor Address: 8400 Union Grove Church Rd City Chapel Hill State: NC Zip: 27516-5410 Department: <br /> CntyMngr Amount: 3000.00 Purpose: Construction of Gold Park Bee Hotel Budget Code(s): $2000: 37601020- <br /> 681058 /$1000 37601020-683001 Vendor# 602735 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ <br /> No Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 10/10/2017 Approved by <br /> Board Yes No Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> ,DocuSigned by: <br /> Department Director's Signature tP'twUS kiruA, Date: 10/30/2017 <br /> '---0A3E81 812836484... <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 /> DocuSigned""by: <br /> ''111L <br /> Office of the Risk Management Office Lisa �,6vvt e tt0 Date: 10/31/2017 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> DocuSigned by: <br /> Offi of the Chief Financial Office c ce q +� d Date: 10/31/2017 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legacfogrm d and sufficiency: <br /> Office of the County Attorne �- 16 Date: 10/31/2017 <br /> 4035CB8304CA4A9... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd(a)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 5 <br />