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DocuSign Envelope ID:C77C009B-6809-4BD1-87DB-D92DA2E2365E <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Tommy Lawrence Electrical Contractors, Inc Party/Vendor Contact Person: Warren Tam <br /> Contact Phone: 336-599-4771 Party/Vendor Address: PO Box 641 City Roxboro State:NC Zip: 27573 Department: <br /> ams Amount: $750.00 Purpose: BOE Flood Light Budget Code(s): 10240320-570001 Vendor# 58196 (N/A if new <br /> vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ❑ <br /> Amendment ❑ Effective Date 9/1/2019 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 by: <br /> Department Director's Signature S&W, AMA Date:9/24/2019 <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 insuran&&A&&ids, specifications,and requirements: <br /> Q�tSA, CbVYn,t b <br /> Office ofr the Risk Management Officer Date:9/24/2019 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner re..0 . n ,yb�e Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer 0..,44. Date:9/24/2019 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form hs�,4fi�'4 <br /> Office of the County Attorney FAAsnssFnAA8465 Date: 9/24/2019 <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 4 <br />