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DocuSign Envelope ID: E28DEA9C-5975-49E1-A066-93E44428E1D5 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Rachel Cotterman Party/Vendor Contact Person: same Contact Phone: (919) 593-5297 <br /> Party/Vendor Address: 4720 Silver Apples Road City Hillsborough State: NC Zip: 27278 Department: DEAPR <br /> Amount; $2,200 Purpose. Harvey's Chapel Historical Research and Landmark A lication Budget Code(s): 61370035 <br /> 850000 20011 Vendor#65424 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: <br /> (Check one)New® Renewal❑ Amendment ❑ Effective Date December 20,2018 Approved by Board Yes❑ <br /> No® Agenda Date:NA <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work on <br /> this project has not been initiated prior to execution of the agreement: <br /> Docusigned by: <br /> Department Director's Signature pav G Sfp vti� Date: 12/21/2018 <br /> pair ar 611CFA1D507A495... ove affirmation. If services related to this <br /> Agreements for emergency services c7rre <br /> agreement have already begun or been completed please briefly describe the nature of the emergency condition that was <br /> addressed: <br /> Information Technologies <br /> (Applicable only to hardwarelsoftware 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 INIana2ement <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> DocuSigned by: <br /> Office of the Risk Management Officer QUSA 12/21/2018 <br /> �,4Wt.t,{�6 Date: <br /> 7FDCF9176900498... <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 Officer Date: 12/21/2018 <br /> 7n4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Docusigned by: <br /> Office of the County Attorney ,� t.S NA, Date: 12/21/2018 <br /> 328DC480548A4F5... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: snngersoll@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 12/18 4 <br />