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DocuSign Envelope ID: F5F11756-CF5A-4BC6-A988-BAC493935201 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Sasser Companies Party/Vendor Contact Person: Kevin Sasser Contact Phone: 336-449-1144 <br /> Party/Vendor Address: PO Box 10 City Whitsett State: NC Zip: 27377 Department: AMS Amount: $650.00 <br /> Purpose: Blackwood Farm House Winterization Budget Code(s): 61370035-800000-20037 Vendor# 65006 (N/A if <br /> new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ❑ <br /> Amendment ❑ Effective Date 3/25/2019 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 /> DocuSigned by: <br /> MAJA, V6V*AJA, 3/21/2019 <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 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 l;&A I6Vds, specifications,and requirements: <br /> Office of the Risk Management Officer Fg�sx C,b�6 Date: 3/22/2019 <br /> 7 FQ-Fff1-7 800498... <br /> Financial Services <br /> This instrument has been pre-audited in the ma 0e ad+Jy:the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer il-N ��z n Date:3/22/2019 <br /> Legal Services <br /> This agreement is approved as to legal for J �'cy: <br /> J L <br /> N 3/22/2019 <br /> Office of the County Attorney FAA------------ 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 12/18 4 <br />