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DocuSign Envelope ID: 7295DAE7 -1 D24- 460B- 843D- 4875267133AA <br />ORANGE COUNTY — DEPARTMENT USE ONLY <br />Department <br />Party/Vendor Name: N.W. Poole Well & Pump Co. Party /Vendor Contact Person: Kevin Letchworth Contact Phone: <br />919 - 265 -9223 Party /Vendor Address: PO Box 1958 City Wendell State: NC Zip: 27591 Department: DEAPR <br />Amount: $2,483.25 Purpose: Repair Irrigation Budget Code(s): 10515020 630000 20025 Vendor # 60487 (N /A if <br />new vendor) Vendor is a BOCC consultant? Yes ❑ NoN Contract Type: (Check one) New ® Renewal ❑ <br />Amendment ❑ Effective Date Approved by Board Yes❑ No❑ Agenda Date: <br />This agreement is approved as to technical form and content: <br />DocuSigned by: r <br />Department Director's Signature awl gatt.a Date: 7/24/2018 <br />611CFA1D507A405... <br />Information Technologies <br />(applicable only to har•cli- var•elsoftrvare 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 QUSX Cb�6 <br />7FDCF917E8o0498... <br />Financial Services <br />Date: 7/30/2018 <br />This instrument has been pre - audited in the manner required by the Local Government Budget and Fiscal Control Act: <br />DocuSigned by: <br />Office of the Chief Financial Officer 17D4E5181ACC1409 .,,, a.af se.. Date: 8/4/2018 <br />. <br />Legal Services <br />This agreement is approved as to legal form and sufficiency: <br />DocuSigned by: <br />Office of the County Attorney , 6L4 L Kk <br />EAAM33ED8AE465... <br />Cleric to the Board <br />Date: 8/7/2018 <br />Received for record retention: <br />All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoftoran eg counlync.goy <br />The following signature block is for hard copies only and is not required for Docusign contracts: <br />Office of the Cleric to the Board Date: <br />Revised 10!17 (Mgr appry 5k 61I8) 4 <br />