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DocuSign Envelope ID:7DO44905-CC77-4EOC-84C3-675B48A32380 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> PartyfVendor Name: Keenan Williams,Electrical Contractor PartyfVendor Contact Person: Keenan Williams Contact <br /> Prone: 919-614-0203 Party/Vendor Address: 730 Eagle Point Rd City Pittsboro State:NC Zip: 27312 Department: <br /> AMS Amount:$875.00 Purpose:WCOB Electrical Budget Code(s): 10240320-570000 Vendor#t 65426 (N/A if new <br /> vendor) Vendor is a BOCC consultant? Yes ❑ No[] Contract Type: (Check one) New ❑ Renewal ❑ <br /> Amendment ❑ Effective Date 2/4/2019 Approved by 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 /> DocuSigned by: <br /> Department Director's Signature 1W PbV*aaA. Date: 1/30/2019 <br /> Agreements for emergency services or repair a.-..:.1.E�:.'�°.CO��E�u. .,bove 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 Technolo0es <br /> (applicable only to hardwarelsofhvare 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 /> Lusk Management <br /> This agreement is approved for sufficiency of pacu5igned_by:.A—A" specifications,and requirements: <br /> Office of the Risk Management Officer [,USX fib b Date:1/30/2019 <br /> 7FDCF9176900498. <br /> Financial Services <br /> This instrument has been pre-audited in the DocuSigned by: `,ocal.Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer 41 .4/� Date:1/30/2019 <br /> 7D4E51S1 ACC 1400- <br /> Legal Services <br /> This agreement is approved as to legal fo �6� K6kk5 1/30/2019 <br /> DocuSigned by: <br /> Office of the County Attorney EAA3D33EDSAW5.. Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@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 4 <br />