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DocuSign Envelope ID:54B72E39-BDA8-4BB5-A805-8F99E054CB43 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Carolina Restoration Services of North Carolina,Inc. Party/Vendor Contact Person: Phil Rhodes <br /> Contact Phone: 919-469-1955 Party/Vendor Address: 3401 Gateway Centre Blvd. City Morrisville State: NC Zip: <br /> 27560 Department: AMS Amount: $1,289.71 Purpose: RENA Emergency Water Mitigation Budget Code(s): <br /> 10240320-570000 Vendor# 63827 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract <br /> Type: (Check one)New ❑ Renewal ❑ Amendment ❑ Effective Date 8/20/2019 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 /> DocuSigned by: <br /> Department Director's Signature 9MA Date:9/19/2019 <br /> 2DD9CDBB81844C5. <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: Emeregncy water/sewage mitigation from sewage back up caused by failed pump. <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 sufficient of insur---- ----=fications and requirements: <br /> g pp y i]ocusigned by: � q <br /> Office of the Risk Management Officer U$6. �,b b Date:10/22/2019 <br /> 7FDCF9176800498. <br /> Financial Services <br /> This instrument has been pre-audited in the7E7NE5181ACC1409 <br /> Docusigned by: Government Budget and Fiscal Control Act: <br /> 11-N <br /> Office of the Chief Financial Officer Date:10/22/2019 <br /> . — - <br /> Legal Services <br /> This agreement is approved as to legal f DocuSigned by: <br /> �6� K6 Y S 10/22/2019 <br /> Office of the County Attorney EAA3D33ED8AW5.. 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 4 <br />