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DocuSign Envelope ID:C1E6582F-30E7-4FFE-8A42-B792ACDE7CD4 <br /> ORANGE COUNTY DEPARTMENT USE ONLY <br /> Party/Vendor Name: Riley Surveying: P.A. Party/Vendor Contact Person: Jose Torres Contact Phone:919-667-0742 <br /> Party/Vendor Address: 3326 Durham Chapel Hill Blvd Suite 13-100 City Durham State:NC Zip. 27707 Department: <br /> DEAPR Amount: $3,600 Purpose: Add survey work Budget Code(s): 61370035 860000 20003 Vendor # 52775 <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New® Renewal <br /> ❑ Amendment ❑ Effective Date August 2,2019 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 /> C1)611CFA1D507A495 <br /> Docusigned by: <br /> Department Director's Signatuam' Sfoail Date: 8/2/2019 <br /> Agreements for emergency service..,-. . -. ,1 ,abject 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 hardwarelsotware 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 sufficienc--f�ocu5 g ed by:r'"'�'rds,specifications,and requirements: <br /> Office of the Risk Management Officer USX LQl^ln� 6 Date: 8/2/2019 <br /> 7FDCF917e800498. <br /> Financial Services <br /> This instrument has been pre-audited i~ pocuSigned by: the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Office Dail: 8/6/2019 <br /> 7D4E5981ACC1409. <br /> Legal Services <br /> This agreement is approved as trt'�o cu5 fined by: —Ticiency: <br /> Office of the County Attorney[�6�i, Pk; 5 Date: 8/7/2019 <br /> EAA3D33ED&AW5.. <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: snngersoll@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 />