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DocuSign Envelope ID:8684E56C-OA47-4C41-A3F9-AE9C772AAF71 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: G2 Designs P.A Party/Vendor Contact Person: Tim Grady Contact Phone: 919-321-0638 <br /> Party/Vendor Address: P.O Box 297 City Apex State:NC Zip: 27502 Department:AMS Amount: $950.00 Purpose: <br /> Seymour Annual Storm Water Control Inspections Budget Code(s): 10240320-630000 Vendor# 64902 (N/A if new <br /> vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ❑ <br /> Amendment ❑ Effective Date 07/01/2019 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 dy- <br /> �W P6V*aan. 7/29/2019 <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 insura Docusigned by: icatlons,and requirements: <br /> 17FDCF0176900498 <br /> usa. LQVIn 6 7/30/2019 <br /> Office of the Risk Management Officer . Date: <br /> Financial Services <br /> This instrument has been pre-audited in the man Docusigned'by: - Government Budget and Fiscal Control Act: <br /> s/JmrxR . 7/30/2019 <br /> Office of the Chief Financial Officer Datc: <br /> 7D4E51S1ACC1409. - <br /> Legal Services <br /> This agreement is approved as to legal form ai [ DocuS.igned by: <br /> Office of the County Attorney � Date: 7/30/2019 <br /> EAA3D33EDSAM65.. <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 />