Orange County NC Website
Browse       Search
DocuSign Envelope ID:4A03D7DC-9143-4585-A738-51E13A50C13F <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Sasser Companies Party/Vendor Contact Person: Kevin Sasser Contact Phone: 336-516-5140 Party/Vendor <br /> 10 City Whittset State: NC Zip: 27337 Department: AMS Amount: $1,875 Purpose: Change Order#1 Budget Code(s): 61370C <br /> Vendor#65006 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New❑ Renewa <br /> ❑ Effective Date 8/13/2019 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 this project has <br /> prior to execution of the agreement: <br /> DocuSigned by: <br /> IS <br /> � 9MA 8/13/2019 <br /> Department Director's Signature Date: <br /> Agreements for emergency services or repair are not suoject to the above affirmation. If services related to this agreement have alread: <br /> completed please briefly describe the nature of the emergency condition that was addressed: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> DocuSiggp'nted_by: <br /> . <br /> Office of the Risk Management Officer aUsa LQ b Date/14/2019 <br /> 7FDCF9176900498. <br /> Financial Services <br /> This instrument has been pre-audited' Docusigned by: the Local Government Budget and Fiscal Control Act: <br /> I 41 � 8/16/2019 <br /> Office of the Chief Financial Office ` Date: <br /> 7D4E51S1ACC1409. <br /> Legal Services <br /> This agreement is approved as tcDEAA3D3aED&AW5_ <br /> ' D"igned by:' _iciency: <br /> Office of the County Attorney6� K6k� Date: 8/19/2019 <br /> . <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 <br />