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DocuSign Envelope ID: B65A93BB-6378-42A0-8340-F9CDBA5AA4BB <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: D.W.Evans Electric,Inc. Party/Vendor Contact Person: Josh Evans Contact Phone: <br /> 919)383-6020 Party/Vendor Address: 3511 Evans Corporate Ln City Durham State: NC Zip: 27705 Department: <br /> Solid Waste Amount: 1,678.00 Purpose: Rewire Light Poles for LED and install LED bulbs at Walnut Budget <br /> Code(s): 50353020-570000 Vendor# 43243 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® <br /> Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date January 24, 2019 Approved by <br /> Board Yes❑No® Agenda Date: <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 /> DSign/e'd11by: <br /> Department Director's Signature <br /> 5ocu <br /> O�euf WlW WAS Date: 1/18/2019 <br /> Agreements for emergency services or r Wject to the above affirmation. If services related to this <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 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 /> DocuSigned""by: <br /> ''ll� <br /> Office of the Risk Management OfficerPUS& rbvvu llb _Date: 1/18/2019 <br /> 7FDCF9176800498... <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 /> 1/18/2019 <br /> Office of the Chief Financial Officer +� Date: <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorney FgKAAJ, kaYtf, 1_�S(0 Date: 1/21/2019 <br /> 079MD525COWB... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@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 />