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DocuSign Envelope ID: 1BBBAFD6-1997-43E8-BE3E-9C058BE528AD <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Summit Design & Engineering Services, PLLC Party/Vendor Contact Person: Don Dewey <br /> (Don.dewey(a)summitde.net) or Troy Dover(Troy.Dover(a)summitde.net) Contact Phone: 919.732.3883 Party/Vendor <br /> Address: 320 Executive Court City Hillsborough State: NC Zip: 27278 Department: AMS Amount: 2000.00 <br /> Purpose: Construction Admin Services for PFAP Freezer Installation Project Budget Code(s): 30600030-870000-71370 <br /> Vendor# 53403 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) <br /> New ® Renewal ❑ Amendment ❑ Effective Date 11/1/19 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 /> Department Director's Signature � t Qnn�k Date: lo/z4/zo19 <br /> C, <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: N/A <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 /> Office of the Risk Management Office QtAs1 bn1t f° Date:10/24/2019 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> PL <br /> Office of the Chief Financial Officer Date:10/2 5/2019 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Office of the County Attorney �' ` ° Date:10/28/2019 <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 />