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DocuSign Envelope ID: BDF3C7B6-01 FE-439B-B71 E-E7DC4694D3B7 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Firebrand Pro, LLC. Party/Vendor Contact Person: Mark H. Mitchell (owner). Contact Phone: <br /> 336-516-0908 Party/Vendor Address: 3348 Winston Drive City Burlington, State: NC Zip: 27215 Department: <br /> Solid Waste Amount: $665.00 Purpose: Mandated Fire Door Inspection Budget Code(s): 50350020- 570000 Vendor <br /> # 65764 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New <br /> Renewal ❑ Amendment ❑ Effective Date October 15,2019 Approved by Board Yes❑No® Agenda Date: <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work on <br /> this project has not been initiated prior to execution of the agreement: <br /> DocuSigned by: <br /> Department Director's Signature �0�� w� A+HS Date:10/10/2019 <br /> 0496. <br /> Agreements for emergency services c.. r�..88E86F84369.., ,»,-,;t to the above affirmation. If services related to this <br /> agreement have already begun or been completed please briefly describe the nature of the emergency condition that was <br /> addressed: <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards, specifications,and requirements: <br /> a <br /> DocuSigned <br /> _by: <br /> . <br /> Office of the Risk Management Officer US66 LQ 6 Datc: 10/10/2019 <br /> 7FDCF9176800498. <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Officer 411.4/� Date:10/11/2019 <br /> 704E51S1ACC1409. <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorney 10/11/2019 <br /> �irt.�t.L ftA.YYf, �$Cb Date: <br /> 079A4D525COF4FB. <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 />