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DocuSign Envelope ID:49C3D6C6-17EB-4320-B1 DF-601984A397F2 <br /> DocuSign Envelope ID:49C3D6C6-17EB-4320-B1DF-601984A397F2 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Summit Design and Engineering Services PLLC Party/Vendor Contact Person: 'Tim Smith <br /> (tim.smith a summitde.net) Contact Phone: 919.732.3883 Party/Vendor Address: 504 Meadowlands Drive City <br /> Hillsborough State: NC Zip: 27278 Department: AMS Amount: 1 650.00 Purpose: Provide storm water BMP <br /> Inspection and Certification for overall storm water system Budget Code(s):61370035-870000-10068 Vendor#53403 <br /> (NIA irnew vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: (Check one)New® Renewal <br /> ❑ Amendment ❑ Effective Date 5/20/2019 Approved by Board Yes❑NoE 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 /> Department Director's Signature Q� �/°nx�n Date: 5/23/2019 <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 was <br /> addressed: N/A <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 gate: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> Office of the Risk Management Office QGs� �a"� d Date: 5/23/2019 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> PL °" <br /> Office of the Chief Financial Officer Date: 5/24/2019 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Office of the County Attorney "I"" ° Date: 5/28/2019 <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@orangecountyne.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 />