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DocuSign Envelope ID:5COB7860-9C32-47EC-829F-BCA5B8OE52B3 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: NCDEQ Division of Water Resources Party/Vendor Contact Person: Tommy Kirby Contact <br /> Phone: 919-707-8529 Party/Vendor Address: 1606 Mail Service Center City Raleigh State: NC Zip: 27699-1606 <br /> Department: Planning Amount: $3,750.00 Purpose: Hydrilla Control 2019 Budget Code(s): 10695020-720013 <br /> Vendor#27873 remit 13 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: (Check <br /> one) New ® Renewal ❑ Amendment ❑ Effective Date October 14, 2019 Approved by Board Yes[-] No® <br /> 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 /> ° se aey <br /> Department Director's Signature Date: 10/9/2019 <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 insurance standards,specifications,and requirements: <br /> ° satley 10/10/2019 <br /> _-_ _,-, ,� <br /> Q�AS&chnv,tb <br /> Office of the Risk Management Officer Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> ° sa eEby: 10/10/2019 <br /> Office of the Chief Financial Officer ('�'A �"" "` Date: <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> eseedy 10/10/2019 <br /> Office of the County Attorneya�t n �"" Date: <br /> ll ]2EDlC[e0S49A4F0 <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//DEQ 7/19 4 <br />