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DocuSign Envelope ID:AOEF7CE6-ECCE-42BB-9495-692DE241D757 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Freehold Land Surveys, Inc Party/Vendor Contact Person: Steve Hallstrom Contact Phone: <br /> 919-929-8090 Party/Vendor Address: 1777 Fordham Blvd., Suite 104 City Chapel Hill State: NC Zip: 27514 <br /> Department: DEAPR Amount: $6,600 Purpose: Provide land survey services to produce a recordable plat for a <br /> conservation easement on Holden-Roberts Farm Budget Code(s): 61370035 899950 20006 Vendor#32666 (N/A <br /> if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New® Renewal ❑ <br /> Amendment ❑ Effective Date April 22,2019 Approved by Board Yes®No❑ Agenda Date: December 11, <br /> 2018-closed session <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work <br /> on this project has not been initiated prior to execution of the agreement: <br /> DocuSigned by: <br /> a�� 5f �� <br /> Department Director's Signa Date:4/26/2019 <br /> Agreements for emergency serv____g 1CFA,❑--- ---5--___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 <br /> was 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 <br /> _by, <br /> . <br /> Office of the Risk Management Of aUsa LQ►►�i6 Date:4/26/2019 <br /> 7FDCF91769004M- <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Ofti Cc <br /> Date:4/29/2019 <br /> 7NE5181ACCAH- <br /> Legal Services <br /> This agreement is approved as to leeal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attor , 6&), Pk�,fs Date:4/29/2019 <br /> EAA3D33ED&AM65-- <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 <br /> 8 <br />