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Revised 10/17 6 <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br /> <br />______________________________________________________________________________ <br />Department <br /> <br />Party/Vendor Name: Century Slate Company Party/Vendor Contact Person: Bradley Schaefer <br />(brad@centuryslate.com) Contact Phone: 919-544-8890 Party/Vendor Address: 1310 E. Cornwallis Road City <br />Durham State: NC Zip: 27713 Department: AMS Amount: $43,255.00 Purpose: Replace slate roof at Skills <br />Development Center Budget Code(s): 61350037-882000-30002 Vendor # 64993 (N/A if new vendor) Vendor is <br />a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective <br />Date March 14, 2018 Approved by Board Yes No Agenda Date: <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 <br />services 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 <br />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 Sherri Ingersoll upon completion: singersoll@orangecountync.gov <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: B49FB256-4ADF-4759-AF63-134AD44FC239 <br /> <br /> <br /> <br /> <br /><br />