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DocuSign Envelope ID:00D5239D-4390-42F1-AA3B-CB88F2EE7089 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Alley, Williams, Carmen & King, Inc. Party/Vendor Contact Person: Ken Stafford <br /> ikstafford @awck.com) Contact Phone: 336.226.5534 Party/Vendor Address: 740 Chapel Hill Road City <br /> Burlington State: NC Zip: 27216 Department: AMS Amount: $8,200.00 Purpose: Design, Bidding & <br /> Construction Administration services for installation of shower at the Cedar Grove Community Center Budget <br /> Code(s): 61370035-870000-10016 Vendor#64820 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ <br /> No Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 10/25/17 Approved by <br /> Board Yes NoZ Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> �--DocuSigned by: <br /> Department Director's Signature 24 °p Date:10/24/2017 <br /> —.880A46C764498... <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 /> D uSg tlby <br /> Office of the Risk Management Office t'sa Cowuffa Date:10/24/2017 <br /> Financial Services <br /> Da This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Vf Act: <br /> r---DOsigea bv: 12/6/2017 <br /> Office of the Chief Financial Officer 1 Date: <br /> —M.5181.0.09... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> l---DocuSigned by: <br /> Office of the County Attorney Date:12/7/2017 <br /> t.AA�,,511tlA646> <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 />