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DocuSign Envelope ID:72B61B9E-DE9C-482C-83A8-84EC6903857F <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Simmons & Simmons Management, Inc. Party/Vendor Contact Person: David Simmons <br /> Contact Phone: 910-592-3834 Party/Vendor Address: P.O. Box 1460 City Clinton State: NC Zip: 28329 <br /> Department: Solid Waste Amount: 7,500.00 Purpose: Grind and Haul Vegetative Debris Budget Code(s): <br /> 50352020-630000 Vendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract <br /> Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date Feb. 10,2019 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 <br /> on this project has not been initiated prior to execution of the agreement: <br /> DocuSign/e'd11by: <br /> F-8BEB6F843690496 <br /> b�et,V� WIAIMS 2/7/2019 <br /> Department Director's Signature Date: <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 <br /> was 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 o * I dards,specifications,and requirements: <br /> Office of the Risk Management Officer gu rbvvulTb Date:2/7/2019 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: DocuSigned by: <br /> ,� , 2/7/2019 <br /> Office of the Chief Financial Officer ('�� Date: <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorney aAx, ha& T�Sc4 Date: 2/7/2019 <br /> 079A4D525COF4FB... <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 <br /> 8 <br />