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DocuSign Envelope ID: D4966361-0983-4ABD-B54D-70D58DB5C632 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Triangle Landscaping Inc. Party/Vendor Contact Person: Brad Lewis Contact Phone: 919 730- <br /> 5267 Party/Vendor Address: PO Box 144 City Stem State: NC Zip: 27581 Department: Asset Management <br /> Amount: $1,145.00 Purpose: Grind concrete in sidewalks and patios at Passmore and Seymour Centers along raised <br /> edges where concrete has subsided. All appropriate PPE will be used during concrete grinding. Budget Code(s): <br /> 10240320-570000 Vendor# 62218 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract <br /> Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date January 22,2019 Approved by Board Yes <br /> ❑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 /> �Doou&gned Wy <br /> [( A" vbmav, <br /> Department Director's Signature t� Date:1/22/2019 <br /> 21EF373ACO454EF <br /> Agreements for emergency services or repair are not subject 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 /> Qtasa �vtiuffb 1/22/2019 <br /> Office of the Risk Management Officer Date: <br /> 7r❑cr❑17MONgE. <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> Docu3igned W, 1/2 3/2019 <br /> Office of the Chief Financial Officer�{� Date: <br /> 7Q4E51MACC1W9 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Docu&!gwd by: <br /> Office of the CountyAttorney rr � 1/24/2019 <br /> y ,�bLs.1rt. Xa�k.V�'s Date: <br /> EA.43GKEMA64G5... <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 />