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DocuSign Envelope ID:855BE64D-4337-4C8B-912D-A231DD8ADD04 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: The Water Specialist Party/Vendor Contact Person: Contact Phone: (919) 732-1578 <br /> Party/Vendor Address: 608 Cornerstone Ct, City Hillsborough State: NC Zip: 27278 Department: Solid Waste <br /> Amount: 4,820.00 Purpose: Well Repair Budget Code(s): Vendor#N/A (N/A if new vendor) Vendor is a <br /> BOCC consultant? Yes ❑No® Contract Type: (Check one)New ® Renewal ❑ Amendment ® Effective Date <br /> May 20,2019 Approved by 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 /> UocuSignedby. <br /> Department Director's Signature2o .88EBU843690496 <br /> OU� AWa*5 Date:5/16/2019 <br /> Agreements for emergency services . ✓ 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 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 /> QocuSigned by: <br /> L,vVln <br /> Office of the Risk Management Officer QUSA &6 Date: 5/16/2019 <br /> 7FDCF9176800498. <br /> Financial Services <br /> This instrument has been pre-audited in the manner reauired by the Local Government Budget and Fiscal Control Act: <br /> DocuSigned by: <br /> ���n. <br /> Office of the Chief Financial Officer A Date:5/20/2019 <br /> 704E51S1ACC1409. <br /> Legal Services <br /> This agreement is approved as to legal fn—and c„ffiic;Pnow <br /> Oocu,5igned by: <br /> �A, t, U(h <br /> � <br /> Office of the County Attorney Date: 5/21/2019 <br /> 079A4D525COF4FB. <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 />