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DocuSign Envelope ID: 28CB79EF -B9B2- 4055 - 9390- 8AF3AAE6894E <br />ORANGE COUNTY — DEPARTMENT USE ONLY <br />Department <br />PartyNendor Name: Tommy Lawrence Electrical Contractors, Inc. PartyNendor Contact Person: Warren Taylor Contact Phone: 336 -599 -4771 <br />Party/Vendor Address: P.O. ]Box 641 City Roxboro State: NC Zip: 27573 Department: DEAPR Amount: $925.00 Purpose: Provide additional <br />underground_electriacl conduit not in original contract Budget Code(s): 6137003588 000020039 Vendor # 34928 (NIA if new vendor) Vendor is a <br />BOCC consultant? Yes ❑ No Contract Type: (Check one) New ❑ Renewal ❑ Amendment ® Effective Date 3/1212018 Approved by Board <br />Yes❑ No® Agenda Date: <br />This agreement is approved as to f-- —A ^)ntent: <br />DocuSigned by: <br />Department Director's Signat C1)611CFA1D507A495 AW" Nv -tA <br />. <br />Date: 3/20/2018 <br />Asset Management <br />(Applicable only to construction contract.O Thk anref—ent h— been reviewed and is approved as to construction services content and specifications: <br />Docu5igned by: <br />Office of the Asset Management Dire C �6 T�'o —ra-o— Date: 3/20/2018 <br />8 <br />9E88C•A48CF64458... <br />Risk Management <br />This agreement is approved for sufficiency of insurance standards, specifications, and requirements: <br />Docu5ign�ed by: <br />Office of the Risk Management Offi SUS& ClrVln.A6 Date: 3/21/2018 <br />7FDCF9176SID0498... <br />Financial Services <br />This instrument has been pre- auditeO ;^ 1ocuSigned by: ..- <br />- -a ly the Local Government Budget and Fiscal Control Act: <br />Office of the Chief Financial Off, <br />704E5181ACC1409... <br />This agreement is approved a clency: <br />'UocuSgned by: - -_ffi <br />Office of the County .A.ttor6 �bk� <br />EAA3033EMAW5... <br />Date: <br />3/21/2018 <br />Legal Services <br />Clerk to the Board <br />ate: <br />3/21/2018 <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 />Office of the Clerk to the Board <br />Revised 10/17 <br />