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DocuSign Envelope ID: D87E10A1-498E-47C9-9A5C-831DF80D8FF1 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Warren-Hay Party/Vendor Contact Person: Ron LaPann Contact Phone: 919-732-4362 <br /> Party/Vendor Address: PO Box 818 City Hillsborough State: NC Zip: 27278 Department: AMS Amount: $1784.00 <br /> Purpose: Historic Courthouse Emergency Compressor replacement Budget Code(s): 10240320-570000 Vendor # <br /> 25352 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ <br /> Renewal❑ Amendment ❑ Effective Date 2/22/2019 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 /> UocuSigned by: <br /> Department Director's Signature Off),40n. Date: 2/23/2019 <br /> 21EF373AC0454EF.. <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: <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 ins Qocusigned by: cations,and requirements: <br /> 17FDCF0176800408 <br /> usa. cbW�.t,{�6 2/25/2019 <br /> Office of the Risk Management Officer . Date: <br /> Financial Services <br /> This instrument has been pre-audited in the man oocusigned by: Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer Date: 2/25/2019 <br /> 7NE5181ACC1409. <br /> Legal Services <br /> This agreement is approved as to legal form and siD6� K6�UocuSigned by: <br /> Office of the County Attorney Date:2/25/2019 <br /> EAA3033E08AE4S5.. <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 />