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DocuSign Envelope ID:43FC2FFB-67E2-4FBC-A5DF-06C16A5500B6 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> a <br /> Department <br /> Party/Vendor Name: Riley Surveying, P.A. Party/Vendor Contact Person: Phil Riley Contact Phone: 919-667-0742 Party/Vend <br /> Durham Chapel Hill Blvd, Ste B-100 City Durham, State: NC Zip: 27707 Department: AMS Amount: $2800 Purpose: Hwy 70 <br /> Additional Mapping&Field Survey Addendum 3 Budget Code(s): CIP 61370035-870000-10051 Vendor#55186 (N/A if new vem <br /> BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective Date Al <br /> Yes❑No❑ Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> DocuSigned by: <br /> Department Director's Signature I—LuL 06m aA, Date:5/15/2019 <br /> 21 EF373ACD454EF... <br /> Asset Management <br /> (Applicable only to construction contracts)This agreement has been reviewed and is approved as to construction services content and <br /> DocuSigned by: <br /> PLIU& VGV%aJA, 5/15/2019 <br /> Office of the Asset Management DirectorDate: <br /> 21 EF373ACD454EF... <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> DocuSigned by: <br /> Office of the Risk Management Officer 59USA, l o�6 Date: 5/15/2019 <br /> 71`DCF9176800498... IDS <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Officer 0././. Date: 5/16/2019 <br /> 7D4F5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by:''..tt�,, 5/16/2 019 <br /> Office of the County Attorney f75L,, r6G t yv Date: <br /> EAA3D33ED8A8465... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydkoran eg countync•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 10/17 <br />