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DocuSign Envelope ID:4469B057-D1AA-45FE-A32F-766286B600AF <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: J.F. Wilkerson Contracting Co.,Inc. Party[Vendor Contact Person: John Patrick Contact Phone: (919) <br /> 467-1829, Ext. 8 Party/Vendor Address: P.O. Box 183 City Morrisville State: NC Zip: 27560 Department: Planning & <br /> Inspections Amount: $4,268.00 Purpose: CO#3 to Construction Base Bid+Alternates 1 &2,Efland Sewer to Mebane,Phase <br /> 2 Extension Budget Code(s): 61370035-880000-30044 Vendor # 55607 (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes ❑ No® Contract Type: (Check one) New ❑ Renewal ❑ Amendment ® Effective Date 05/25/2019 <br /> Approved by Board Yes®No❑ Agenda Date:06/20/2017 (BOCC delegated authority for CO's to County Manager) <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this <br /> project has not been initiated prior to execution of the agreement: <br /> DocuSigned by: <br /> �rN,_ <br /> Department Director's Signature "' a ,2..� � � �� Date: 5/23/2019 <br /> Agreements for emergency services or ref s4aa,oDA3CFD4c2. e above affirmation. If services related to this agreement have <br /> already begun or been completed please briefly describe the nature of the emergency condition that was addressed: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards, specifications,and requirements: <br /> Docusigned by: 5/2 3/2019 <br /> Office of the Risk Management Officer aUS66 (,6�6 Date: <br /> 7FDCF91768004M. <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: 5/24/2019 <br /> Office of the Chief Financial Officer ( Date: <br /> 7NE5181ACC1409. <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Do"Signed by- <br /> Office of the County Attorney �amGs avu Date: 5/28/2019 <br /> 328DC480549A4F5.. <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 />