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DocuSign Envelope ID:OF3CBAA5-F1E7-4C48-9A21-E5DEFDB7B21B <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 Co atty w/HR&R from 200 S Cameron to Sinclair for Link remediation <br /> rp oject Budget Code(s): 10240320-580000 Vendor# 65179 (N/A if new vendor) Vendor is a BOCC consultant? <br /> Yes ❑No❑ Contract Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date Approved by <br /> 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 /> Department Director's Signature 59(ou v6mavu Date: 4/1/2019 <br /> Agreements for emergency services or repair F�% gt4&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 insurance standards, specifications,and requirements: <br /> DocuSigned by: <br /> PUS& (h0 6 <br /> Office of the Risk Management Officer Date:4/1/2019 <br /> 7FDCF9176800498... F <br /> Financial Services <br /> This instrument has been pre-audited in the mr,6, <br /> E&, j ,�,:by the Local Government Budget and Fiscal Control Act: <br /> Q Do.,a/do., 4/3/2019 <br /> Office of the Chief Financial Officer Date: <br /> 7NE5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal forma", ffigi ligq: <br /> ,Office of the County Attorney Date:4/4/2019 <br /> EAA3D33EDSA8465... <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 />