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DocuSign Envelope ID: D4F4D558-4D88-42A1-8AC5-6F8A5796E6E0 <br /> oS <br /> ORANGE COUNTY—DEPARTMENT USE ONLY K15 <br /> Party/Vendor Name: Chapel Hill Moving Party/Vendor Contact Person: Ethan Smith Contact Phone: 919.929.6683 <br /> Party/Vendor Address: 7401 Rex Rd, Suite 104 City Chapel Hill State:NC Zip: 27516 Department: AMS Amount: <br /> NTE $1530 Purpose: relocate offices in Court Street Annex Budget Code(s): 10700020-665000 Vendor # 65179 <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one)New❑ Renewal <br /> ❑ Amendment ❑ Effective Date 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 /> �W �dV�►a0L 2/28/2019 <br /> Department Director's Signature +1 Date: <br /> Agreements for emergency services or repair 21 EF373ACD454EF.. 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 inc„rnnoP ctnndnrdQ specifications,and requirements: <br /> DocuSigned by: <br /> 6 , 6 <br /> Office of the Risk Management Officer 9US66 (' Date: 2/28/2019 <br /> 7FOCF917e800498. DS <br /> Financial Services Ir <br /> F <br /> This instrument has been pre-audited in the­p;--;ned dy,a I—`''"Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer��MCC1409 <br /> 011.z " Date: 2/28/2019 <br /> . <br /> Legal Services <br /> This agreement is approved as to legal form- 'ooc s;g�ea ini; <br /> Office of the County Attorney �66A, K6k'6 Date: 2/28/2019 <br /> EAA3D33ED&AW5.. <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 />