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DocuSign Envelope ID:6B6FDE8C-BB7C-4270-8B4F-E2FEA17AA582 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> PartyNendor Name: Keenan A. Williams,NC Electrical Contractor PartyNendor Contact Person: Keenan Williams <br /> Contact Phone: 919-614-0203 Party/Vendor Address: 730 Eagle Point Road City Pittsboro State: NC Zip: 27312 <br /> Department:AMS Amount: $1619.00 Purpose: Gateway Tax Electrical Budget Code(s): 10335030-803000 Vendor# <br /> 65426 (N/A if new vendor) Vendor is a BGCC consultant? Yes ❑ No❑ Contract Type: (Check one)New ❑ <br /> Renewal❑ Amendment ❑ Effective Date 11/30/2018 Approved by Board Yes❑No[] Agenda Date: <br /> This agreement is approved as to technical form Docusigne Pbl*NA.d dy: <br /> Department Director's Signature Date: 11/29/2018 <br /> 21EF373ACD454EF... <br /> Information Technologies <br /> (Applicable only to har&var•elsoftivare 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 i------�ocu5ignedby: 3ecifieations,and requirements: <br /> Office of the Risk Management Officer SUS& Ct'iV'ln.A6 Date 11/30/2018. <br /> 7FDCF9178800498... <br /> Financial Services <br /> This instrument has been pre-audited In thf"" Docusigned by: <br /> f 1"'"'Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer Date: 11/30/2018 <br /> 7D4E51&1ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal Docusigned by: <br /> I�, <br /> �b� K6k 12/3/2018 <br /> Office of the County Attorney ElAM33ED&AW5... Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts inust be copied to Sherri Ingersoll upon completion: singerso1l(@oran_ecountync.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 /> f <br /> Revised 10117(Mgr appry A 6118) 4 <br />