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DocuSign Envelope ID:6ADE3670-5672-4DD4-B793-654D507901E1 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Warren Hay Mechanical Contrators Inc. Party/Vendor Contact Person: Ron LaPann <br /> (ron.lapannnwarren-ham)_ Contact Phone: 919-732-4362 Party/Vendor Address: PO Box 818 City Hillsborough State: <br /> NC Zip: 27278 Department: AMS Amount: $50,885.00 Purpose: Boiler Pipe Replacemnet at Whitted Building, 300 West <br /> Tryon Street, Hillsborough NC, includes removal of existing pipe Budget Code(s): 61370035-880000-10075 Vendor # <br /> 614503 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New ® Renewal <br /> ❑ Amendment ❑ Effective Date 08/28/2019 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 <br /> project has not been initiated prior to execution of the agreement: <br /> D 5' d by: <br /> Department Director's Signature Sfw�Q,Vt1¢ 8/29/2019 <br /> Date: <br /> Agreements for emergency services or repair are not subject to the above affirmation. If services related to this agreement have <br /> already begun or been completed please briefly describe the nature of the emergency condition that was addressed: N/A <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> D s'g a by: <br /> Office of the Risk Management Officer a(asa 6....: Date: 8/29/2019 <br /> ,FDDF9t]8 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> 11F" <br /> D s'g a by: <br /> Office of the Chief Financial Office �" Date: 8/30/2019 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> D s'g a by: <br /> Office of the County AttorneyaZ',R6i LA Date 9/3/2019 <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 11 <br />