Orange County NC Website
Browse       Search
DocuSign Envelope ID:63E81679-OC83-4B6C-B9E4-AFBB81985720 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: NCDOT Party/Vendor Contact Person: Beth Gay Contact Phone: 919.707.4691 <br /> Party/Vendor Address: 1501 Mail Service Center City Raleigh State:NC Zip: 27699 Department: Transportation <br /> Services Amount: $174,960 Purpose: Award Amount Budget Code(s): 445002/10435020 Vendor# 14415 (N/A <br /> if new vendor) Vendor is a BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New❑ Renewal ❑ <br /> Amendment ❑ Effective Date 10/9 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 <br /> on this project has not been initiated prior to execution of the agreement: <br /> DocuSigned by: <br /> Department Director's Signature Date: 10/9/2019 <br /> 722E5DDOAB25490 . <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 <br /> was 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 sufficienc -oocusigned by, rds,specifications,and requirements: <br /> ��tSa �,bV1n.C,{f b 10/10/2019 <br /> Office of the Risk Management Officer 7FDCF91769004M. Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: DocuSigned by: <br /> 4 10/11/2019 <br /> Office of the Chief Financial Officer 1ACCAN- Date: <br /> Legal Services <br /> This agreement is approved as t DocuSigned by: -,iency: <br /> �c t,S NA, 10/11/2019 <br /> Office of the County Attorney 328DC48n549A4F5.. Date: <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 />