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c;LC) J q () <br /> ^' <br /> ORANGE COUNTY- - -DEPARTMENT USE ONLY- mmHARD COPY ONLY <br /> Department <br /> Party/Vendor Name : Moffat Pipe Inc Party/Vendor Contact Person : Jesse DuClau Contact Phone : 919=235 -5149 <br /> Party/Vendor Address : 4901 Unicorn Dr . City Wake Forest State : NC Zip : 27587 Department : Planning & <br /> Inspections Amount : $ 5 , 928 . 93 Purpose : Change Order # 7 Budget Code(s) : 61370035 - 8800040054 PO# 1801056 <br /> Vendor # 64870 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No ® Contract Type : (Check one) <br /> New ❑ Renewal ❑ Amendment ❑ Effective Date Approved by Board Yes ❑ No ❑ Agenda <br /> Date . <br /> This agreement is approved as to tec cal form and cont t : <br /> � l <br /> Department Director ' s Signature Date : <br /> l. � <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 /> Office of Risk Management / � , t i , Date : ! ' g <br /> �T <br /> Financial Services <br /> This instrument has been pre- audited in the er require b the Local Government Budget and Fiscal Control <br /> Act . <br /> Office of the Chief Financial Officer Date . f <br /> Legal Services <br /> This agreement is approved as to legal or <br /> d suffic ' ncy : <br /> Office of the County Attorney Date . J <br /> Clerk to the Board <br /> Received for record retention : <br /> Office of the Clerk to the Board Date . <br /> Revised 6/ 16 <br />