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DocuSign Envelope ID: B6103DC0-CF8C-49CD-9CA8-FD1B3B315C92 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: McQueen Construction Inc. PartyNendor Contact Person: Haryy McQueen Contact Phone: <br /> 919-967-0614 Party/Vendor Address: 619 Patrick Road City Bahama State: NC Zip: 27503 Department: DEAPR <br /> Amount: $1500 Purpose: Repair Budget Code(s): 61370035 880000 20439 Vendor #30928 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New Renewal ❑ Amendment ❑ I <br /> Effective Date October 15th Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> DocuSigned by: <br /> Department Director's Signatur �AyM sf alida Date: 10/11/2018 <br /> 611 CFA1 D507A495... <br /> .Information Technologies <br /> (Applicable only to harativarelsoftware 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 /> DocuSiged by: <br /> Office of the Risk Management Office C7111111'11�iS#- b Date:10/11/2018 <br /> 800498... <br /> Financial Services <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 Officez Cd_117D4E5181ACC1409 a�. <br /> 10/12/2018 <br /> _ <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorne )ALA, I°DLit,Vl!S -Date:10/12/2018 <br /> .. <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersollGc oran eg coun nc,go_y <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 6/18) 4 <br />