R 2014-653 DEAPR - Wilkerson culverts and standpipe repair

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Revised 7/14 4 ORANGE COUNTY—DEPARTMENT USE ONLY NOT A CONTRACT EXHIBIT OR ATTACHMENT ______________________________________________________________________________ Department Party/Vendor Name: Wilkerson Grading Party/Vendor Contact Person: Paul Wilkerson Contact Phone: 919 732-2579 Party/Vendor Address: 4600 Brock Drive City Hurdle Mills State: NC Zip: 27541 Department: DEAPR Amount: $7,664.37 Purpose: Culvert and Standpipe Repair Budget Code(s): 61370035 880000 20039 Vendor # 61663 (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date 8/20/2014 Approved by Board Yes No Agenda Date: n/a This agreement is approved as to technical form and content: Department Director’s Signature ________________________________________ Date: ________ Information Technologies (Applicable only to hardware/software purchases or related services) This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Director of Information Technology___________________________ Date: ________ Risk Management This agreement is approved for sufficiency of insurance standards, specifications, and requirements: Office of Risk Management_____________________________________________ Date: _________ Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer ____________________________________ Date: _________ Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney __________________________________________Date: ________ Clerk to the Board Received for record retention: Office of the Clerk to the Board __________________________________________Date:_________ DocuSign Envelope ID: AAA0C5ED-79C0-411C-A374-A0EB1685C67E