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DocuSign Envelope ID:56BOBE7E-B86E-4A2F-BD6E-F38644049C65 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Warren-Hay Party/Vendor Contact Person: Ron LaPann Contact Phone: 919-732-4362 <br /> Party/Vendor Address: PO Box 818 City Hillsborough State: NC Zip: 27278 Department: AMS Amount: $360.00 <br /> Purpose: Skills Condenser unit Budget Code(s): 10240320-570000 Vendor#25352 (N/A if new vendor) Vendor is <br /> a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ❑ Amendment ❑ Effective <br /> Date 9/25/2019 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 /> ocuSigned by: <br /> Department Director's Signature 9MA Date: 10/17/2019 <br /> ED DD9CDBB81844C5. <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: Per Paul Sorrell,2nd visit from Warren Hay. Called out immediately due to water running into office <br /> 116&117.This unit also runs office areas for additional employees not affected by the water leak. 116&117 rooms were <br /> deemed unsafe due to water intrusion. <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 in QocuSigned by: -cifications,and requirements: <br /> 1 <br /> U56 (ham 6 10/23/2019 <br /> Office of the Risk Management Officer 7FDCF0176800408. Dale: <br /> Financial Services <br /> This instrument has been pre-audited in the m Docusigned by-:- - cal Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer 0 Date:1012 3/2019 <br /> 704E51 S 1 ACC AN- <br /> Legal Services <br /> This agreement is approved as to legal form DoeuSigned by: <br /> Office of the County Attorney �66A, K6k'6 Date:10/24/2019 <br /> EAA3033ED&AW5.. <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 />