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Revised 2/17 6 <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br /> <br />______________________________________________________________________________ <br />Department <br /> <br />Party/Vendor Name: Triangle Landscaping, Inc Party/Vendor Contact Person: Brad Lewis <br />(trianglelandscapemgmt@gmail.com) Contact Phone: 919-730-5267 Party/Vendor Address: PO Box 144 City <br />Stem State: NC Zip: 27581 Department: AMS Amount: $1,130.00 Purpose: Install 4" steel pole for security <br />camera at the AMS North Fuel station Budget Code(s): 61370035-880000-30001 Vendor # 62218 (N/A if new <br />vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal <br />Amendment Effective Date October 30, 2017 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 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 />DocuSign Envelope ID: 1521D402-2DD6-4112-9C1D-31D6228F9535 <br /> <br /> <br /> <br /> <br />