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o �� - � 1 . <br /> ORANGE COUNTY---DEPARTMENT USE ONLY---HARD COPY ONLY <br /> Department P N* 115?010 5(0 <br /> Party/Vendor Name: Moffat Pipe Inc Party/Vendor Contact Person: Jesse DuClau Contact Phone: 919-231-5149 <br /> Party/Vendor Address: 4901 Unicom Dr. City Wake Forest State: NC Zip: 27587 Department: Plan6ing <br /> Inspections Amount: $181,593.97 Purpose: Change Order Budget Code(s): 61370035-88000-10054. endor <br /> 64870 (N/A if new vendor) Vendor is a BOCC consultant? Yes [l No® Contract Type: (Check on New � ( <br /> Renewal M Amendment ® Effective Date Approved by Board Yes®No❑ Agenda Date: <br /> This agreement is approved as to technical fo an tent: <br /> 7 <br /> Department Director's Signatur Date: C� <br /> Information Technologies <br /> (Applicable only to hardware/software 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 Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> Office of Risk Management_ Date: <br /> Financial Se ices <br /> This instrument has been pre-audited in theAmner rrejuby the Local Government Budget and Fiscal Control <br /> Act: c <br /> Office of the Chief Financial Officer Date: ` Zl 1 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Gl? 1014a u.r <br /> Office of the County Attorney Date: 0 �� <br /> Clerk to the Board <br /> Received for record retention: <br /> Office of the Clerk to the Board _ Date: <br /> Revised 6/16 <br /> I <br />