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DocuSign Envelope ID:5F379893-6C3D-49CA-AAAA-1A8324084F83 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Poythress Tents, Tables & Chairs Party/Vendor Contact Person: David Po. Kress Contact <br /> Phone: 336-446-0434 Party/Vendor Address: PO Box 55 City Gibsonville State: NC Zip: 27249 Department: <br /> DEAPR-Recreation Amount: $1,804.08 Purpose: Tent Rental Budget Code(s): 10511020-630000 Vendor # <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New ® Renewal <br /> ❑ Amendment ❑ Effective Date 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 /> [pawl <br /> �f��L DocuSigned by: r <br /> Department Director's Signature Date:10/21/2019 <br /> 611CFA1D507A495.. <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: David Stancil,DEAPR Director <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: <br /> ."� ' ids,specifications,and requirements: <br /> aUsa (D b 10/22/2019 <br /> Office of the Risk Management Officer 7FDCF9176800498. Date: <br /> Financial Services <br /> This instrument has been pre-audited ii Docusigned by: the Local Government Budget and Fiscal Control Act: <br /> 4 10/22/2019 <br /> Office of the Chief Financial Officer ` 7D4 81AMA09. Date: _ <br /> Legal Services <br /> This agreement is approved as tc Docusigned by: _iciency: <br /> Office of the County AttorneyD6LW �bk� Date: 10/22/2019 <br /> EAA3MaEMAW&— <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 /> P Ds <br /> CS <br />