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DocuSign Envelope ID: D21DFDE8-B7C1-4E75-A803-A1EBD9C48D25 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: FTS- Ferguson Transit Solutions, LLC Party/Vendor Contact Person: Terry Ferguson <br /> Contact Phone: 678-227-4936 Party/Vendor Address: 675 Crowe Road City Statham State: GA Zip: 30666 <br /> Department: OCPT Amount: $25,000 Purpose: Consultations Budget Code(s): 630000 Vendor# 65495 (N/A if <br /> new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New ® Renewal ❑ <br /> Amendment ❑ Effective Date 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 <br /> on this project has not been initiated prior to execution of the agreement: <br /> DocuSigned by: <br /> Department Director's Signature II�y� Date: 7/2/2019 <br /> 722E5DD0A625490 . <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 /> Risk Management <br /> This agreement is approved for sufficiency of insu DocuSigned by: ifications,and requirements: <br /> 1 <br /> U56 (4�6 7/3/2019 <br /> Office of the Risk Management Officer 7FDCF0176800408. 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: DocuSigned dy- <br /> 7/3/2019 <br /> Office of the Chief Financial Officer 17NE5181ACC1409. Date: <br /> Legal Services <br /> This agreement is approved as to legal form and si �ocuSigneddIGS by: <br /> Office of the County Attorney � Date: 7/3/2019 <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 o DocuSigned by: for Docusign contracts: <br /> bltilrt� � � 7/9/2019 <br /> Office of the Clerk to the Board Date: <br /> E7E61BYCO8734DE.. <br /> Revised 12/18 <br /> 8 <br />