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<br />Revised 10/17 <br /> <br /> <br />8 <br /> <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br /> <br />______________________________________________________________________________ <br />Department <br /> <br />Party/Vendor Name: H.M. Kern Corporation Party/Vendor Contact Person: Jason Kepley (JKepley@hmkern.com) Contact <br />Phone: 336.668.3213 Party/Vendor Address: 160 Thatcher Road City Greensboro State: NC Zip: 27409 Department: AMS <br />Amount: Base Bid $524,700 - VE Options $29,880.00 = $494,820.00 Purpose: Passmore Center Expansion Construction <br />Budget Code(s): 61370035-880000-10023 Vendor # 60426 (N/A if new vendor) Vendor is a BOCC consultant? Yes <br />No Contract Type: (Check one) New Renewal Amendment Effective Date 1/23/2018 Approved by Board <br />Yes No Agenda Date: 1/23/2018 <br /> <br />This agreement is approved as to technical form and content: <br /> <br />Department Director’s Signature ________________________________________ Date: ________ <br /> <br /> <br />Asset Management <br /> <br />(Applicable only to construction contracts) This agreement has been reviewed and is approved as to construction services <br />content and specifications: <br /> <br />Office of the Asset Management Director__________________________________ Date: ________ <br /> <br /> <br />Risk Management <br /> <br />This agreement is approved for sufficiency of insurance standards, specifications, and requirements: <br /> <br />Office of the Risk Management Officer___________________________________ Date: _________ <br /> <br /> <br />Financial Services <br /> <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br /> <br /> <br />Legal Services <br /> <br />This agreement is approved as to legal form and sufficiency: <br /> <br />Office of the County Attorney __________________________________________Date: ________ <br /> <br /> <br />Clerk to the Board <br /> <br />Received for record retention: <br />All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecountync.gov <br /> <br />The following signature block is for hard copies only and is not required for Docusign contracts: <br /> <br />Office of the Clerk to the Board __________________________________________Date:_________ <br />DocuSign Envelope ID: 313DA256-1EDE-4396-A716-4C53B809027E <br /> <br /> <br /> <br /> <br />