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DocuSign Envelope ID: FE2D5F70-64AE-410D-A6C6-DD13D47242FB <br /> GRANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Miracle Recreation Equipment_Company Party/Vendor Contact Person: Kevin Walker <br /> Contact Phone: 888-458-2752 Party/Vendor Address: 878 E Highway 60 City Monett State: MO Zip: 65708 <br /> Department: DEAPR Amount: $8,312.60 Purpose: Playground repair Budget Code(s): 61370035 800000 20039 <br /> Vendor#53998 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: (Check one) <br /> New® Renewal❑ Amendment ❑ Effective Date Feb 1,2019 Approved by Board Yes❑No❑ Agenda <br /> Date: <br /> This agreement is approved as to technical form,and content and 1 as Department Director affirmatively state work <br /> on this project has not been initiated prior to execution of the agreement: <br /> DocuSigned by: <br /> L Date:1/29/2019 <br /> Department Director's Signature u��IAIn,Gt� <br /> Agreements for emergency services tpaij,u�,iaWpbject 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 <br /> was addressed: <br /> Information Technologies <br /> (Applicable only to hardwarelsojhvare 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 /> Office of the Risk Management Officer aura, KV1t& Date: 1/29/2019 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: <br /> DocuSigned by: <br /> Office of the Chief Financial OfficeC-9 __ �7 1/30/2019 <br /> ,(�ONQId ON 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 66" Date: 1/30/2019 <br /> EWD33EDW465... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: siggersoll©orangecountyne.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 <br /> 8 <br />