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DocuSign Envelope ID:876AD9F4-8OE8-4EOE-8D72-4AF651E99D75 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Riley Surveying, P.A. Party/Vendor Contact Person: Phillip W. Riley <br /> (nhilr@rileysurveyingpa.com) Contact Phone: 919.667.0742 Party/Vendor Address: 3626 Durham Chapel HIII Ste B- <br /> 100 City Durham State:NC Zip:2777 Department:AMS Amount: $950 Purpose: Merin Road-Public R/W Staking <br /> Budget Code(s): 61370035 880000 10066 Vendor# 57225 (N/A if new vendor) Vendor is a BOCC consultant? <br /> Yes ❑ No® Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 2/15/19 Approved <br /> 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 /> �/anxn� 2/13/2019 <br /> Department Director's Signature IX 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 was <br /> addressed: N/A <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 the Risk Management Officer QGs� �a��#f° Date: 2/13/2019 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> PLo�vsa�� <br /> Office of the Chief Financial Office �N Date:z/1s/zo19 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> COffice of the County Attorney Date:��^ ��° 2/19/2019.,==-R P <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 />