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DocuSign Envelope ID:5C8F1523-AE23-4D8E-9C19-C2404873B86F <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: H.M Kern Party/Vendor Contact Person: Justin Graves(j aves(c4hmkern.com) Contact Phone: 336.668.3213 Party/Vendor <br /> Address: 160 Thatcher Road City Greensboro State:NC Zip: 27419 Department: AMS Amount: 4587 Purpose: Change Order to landscaping, <br /> steps,crash bar and lock Budget Code(s):61370035-880000-10023 Vendor#60426 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑ <br /> No® Contract Type:(Check one)New❑ Renewal❑ Amendment ® Effective Date 12-21-2018 Approved by Board Yes❑No® Agenda <br /> Date: <br /> This agreement is approved as to technical form and content: <br /> Department Director's Signature 1�a'S Date:12/21/2018 <br /> Asset Management <br /> (Applicable only to construction contracts)This agreement has been reviewed and is approved as to construction services content and specifications: <br /> Office of the Asset Management Directm Date 12/21/2018 <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> Office of the Risk Management Office dLsn ianut Date:12/21/2018 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> pl� nnw�ev,- <br /> r <br /> Office of the Chief Financial Officer Date: 3/20/2019 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> ,�SL,+n, 'el�.r!s 3/21/2019 <br /> Office of the County Attorney[u„9I.,.., Date: <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 10/17 <br />