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DocuSign Envelope ID: DAD8677E-5BD9-49A9-8752-89E081765EE6 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Froehling & Robertson, Inc. Party/Vendor Contact Person: Santhosh K. Mahavadi, P.E. <br /> Contact Phone: 919-719-1849 Party/Vendor Address: 310 Hubert Street City Raleigh State: NC Zip: 27603 <br /> Department: Planning Amount: $10,400.00 Purpose: Concrete Testing at the Lake Orange Dam Budget Code(s): <br /> 10695020-720013 Vendor#55185 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract <br /> Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date May 15,2019 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 <br /> on this project has not been initiated prior to execution of the agreement: <br /> N.31g,.d w.. <br /> Department Directors Signature 1E <br /> Date: 5/13/2019 <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 <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 /> G� Slg q l,}: <br /> Q�Sx bnu_f,t 5/13/2019 <br /> Office of the Risk Management OfficeEINEr"„E�,� Date: <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 /> N Slg.dW. 5/13/2019 <br /> Office of the Chief Financial Officer[ 61C, _ Date: <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> X."W 5/13/2019 <br /> Cie s tau <br /> Office of the County Attorney 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 <br /> 8 <br />