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DocuSign Envelope ID:853791D8-E130-4B55-8BEE-AD1847FE0952 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Chapel Hill Moving Company Party/Vendor Contact Person: Ethan Smith Contact Phone: <br /> 919-929-6683 Party/Vendor Address: 7401 Rex Road, Suite 104 City Chapel Hill State:NC Zip: 27516 Department: <br /> AMS Amount: NTE $5000 Purpose: Move PD across hall at 200 S Cameron for Link remediation project Budget <br /> Code(s): 10240320-580000 Vendor# 65179 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ <br /> Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date Approved by Board Yes <br /> ❑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 /> Department Director's Signature Ptou v6ma A, Date:4/1/2019 <br /> Agreements for emergency services or repair are §tffPMq f -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 insuroaon s 9�a b dards, specifications,and requirements: <br /> Office of the Risk Management Officer PUS& rb�6 Date: 4/1/2019 <br /> 7FDCF9176800498... Lp <br /> Financial Services <br /> This instrument has been pre-audited in the mannersr9oyFd by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer �Q �O"Q�dO" Date: 4/3/2019 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form an susfficncy: <br /> igne y:56,ocu <br /> �b ty► 4/4/2019 <br /> Office of the County Attorney Date: <br /> EAA3D33ED8A8465... <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 />