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ao <br /> ( q <br /> ORANGE COUNTY-==DEPARTMENT USE ONLY- - -HARD COPY ONLY <br /> Department <br /> Party/Vendor Name : Moffat Pipe , Inc . Party/Vendor Contact Person : Chris Pearson Contact Phone : 919 -235 - 5149 <br /> Party/Vendor Address : 4901 Unicorn Dr . City Wake Forest State : NC Zip : 27587 Department : Planning_& <br /> Inspections Amount : $ 10 , 598 . 22 Purpose : Rogers Road Sewer - Change Order #5 Budget Code (s) : 61370035 - <br /> 8800040054 Vendor # 64870 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No ® Contract Type : <br /> (Check one) New ❑ Renewal ❑ Amendment ® Effective Date September 24 , 2018 Approved by Board Yes <br /> ❑ No ❑ Agenda Date : <br /> PO # 1801056 Change Order # 9 <br /> This agreement is approved as to technical f in q4ufqnt <br /> Department Director ' s Signature Date : <br /> Information Teftologies <br /> (Applicable only to hardware/software purchas Phis agreement has been reviewed and is <br /> approved as to information technology conten <br /> Office of the Chief Information Officer Dat - - <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards , specifications, and requirements . <br /> Office of Risk Management Date : 1 OF/ <br /> l �' <br /> Financial Services <br /> This instrument has been pre- audited in;the anne r ired b the Local Government Budget and Fiscal Control <br /> Act : / <br /> Office of the Chief Financial Officer god Date . <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency : <br /> Office of the County Attorney Date . <br /> Clerk to the Board <br /> Received for record retention : <br /> Office of the Clerk to the Board Date . 7, 9' � l <br /> Revised 6/ 16 <br />