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DocuSign Envelope ID:4FD8846F-39DA-44B5-8EF6-437A8F54875D <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Rice's Glass Company Party/Vendor Contact Person: Contact Phone: 919-967-9214 <br /> Party/Vendor Address: 107 Lloyd St City Carrboro State: NC Zip: 27510 Department: AMS Amount: $741.19 <br /> Purpose: Central Recreation Stairwell Glass Replacement Budget Code(s): 10240320-57000 Vendor# 104 (N/A if <br /> new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ❑ <br /> Amendment ❑ Effective Date 7/22/2019 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 /> DocuSigned by: <br /> CA& P6V*aaA, 7/12/2019 <br /> Department Director's Signature 21 EF373ACD454EF.. Date: <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: <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 11 DocuSigned by: )ecifications,and requirements: <br /> �sa' �,oVln.��b <br /> Office of1g7FDCF91768004M the Risk Management Officer . Date:7/15/2019 <br /> Financial Services <br /> This instrument has been pre-audited in the manner DocuSigned by: — vernment Budget and Fiscal Control Act: <br /> 41 .&1w 7/15/2019 <br /> Office of the Chief Financial Officer Date: <br /> 7NE5181ACCAH <br /> Legal Services <br /> This agreement is approved as to legal DocuSigned by: <br /> , 66A, K6kY S 7/16/2019 <br /> Office of the County Attorney EA43D33ED8A905.. Date: <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 />