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DocuSign Envelope ID: F52FF19B- 033A- 43E6- 810E- 5875E4911113 <br />ORANGE COUNTY- DEPARTMENT USE ONLY <br />Department <br />Party/Vendor Name: MdM Historical Consultants Party/Vendor Contact Person: Jennifer Martin Contact Phone: <br />(919) 368 -1602 Party /Vendor Address: PO Box 1399 City Durham State: NC Zip: 27702 Department: DBAPR <br />Amount: $3,500 Purpose: National Register Nomination for Cedar Grove School Budget Code(s): 61370035 <br />850000 20011 Vendor # 62927 (N /A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract <br />Type: (Check one) New H Renewal ❑ Amendment ❑ Effective Date March 14. 2018 Approved by Board <br />Yes❑ NoID Agenda Date: NA <br />This agreement is approved as to technical form and content: <br />DocuSigned by: <br />Department Director's Signature Sfo dt Date: 3/14/2018 <br />81iCFA1D597A495... <br />Information TechnoloLyies <br />(Applicable only to hardwaralsofrwware 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 <br />Risk Management <br />Date: <br />This agreement is approved for sufficiency of insurance standards, specifications, and requirements: <br />DocuSigned by: <br />Office of the Risk Management Officer U$0, Cby'lit,Gf �6 Date: 3/15/2018 <br />7FDCF9176900498... <br />Financial Services <br />This instrument has been pre - audited in the manner required by the Local Government Budget and Fiscal Control <br />Act: <br />DocuSigned by: <br />Office of the Chief Financial Officer � s�Jaa <br />7NE5181ACC1469... <br />Legal Services <br />This agreement is approved as to legal form and sufficiency: <br />DocuSigned by: <br />Office of the County Attorney �cuGS' <br />328DC480549A4F5.... <br />Clerk to the Board <br />Date: 3/15/2018 <br />Date: 3/15/2018 <br />Received for record retention: <br />All Docusign contracts must be copied to Sherri Ingersoll upon completion: san eg rsoll 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 10/17 <br />