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ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br />Department <br />Party/Vendor Name: Gonzalez Painters & Contractors, IncParty/Vendor Contact Person: Florencio Gonzalez <br />Contact Phone: 919-477-6058Party/Vendor Address: 4302 Bennett Memorial RoadCity DurhamState: NCZip: <br />27705Department: AMSAmount: $9750Purpose: Link lower level interior waterproofingBudget Code(s): <br />61370035-880000-30002Vendor # 61921(N/A if new vendor) Vendor is a BOCC consultant? Yes No <br />Contract Type: (Check one) New Renewal Amendment Effective Date 07/25/2018Approved by Board <br />Yes No Agenda Date: <br />This agreement is approved as to technical form and content: <br />Department Director’s Signature ________________________________________ Date: ________ <br />Asset Management <br />(Applicable only to construction contracts) This agreement has been reviewed and is approved as toconstruction <br />servicescontent and specifications: <br />Office of the Asset Management Director__________________________________ Date: ________ <br />Risk Management <br />This agreement is approved for sufficiency of insurance standards, specifications, and requirements: <br />Office of the Risk Management Officer___________________________________ Date: _________ <br />Financial Services <br />This instrument has been pre-audited in the manner required bythe Local Government Budget and Fiscal Control <br />Act: <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br />Legal Services <br />This agreement is approved as to legal form and sufficiency: <br />Office of the County Attorney __________________________________________Date: ________ <br />Clerk to the Board <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 __________________________________________Date:_________ <br />Revised 10/17 6 <br />DocuSign Envelope ID: C525D914-C9F9-41C7-B0B4-962FB2B66847 <br /> <br /> <br /> <br />