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DocuSign Envelope ID: F1B32247-7AA8-4384-AB50-83A2F9738D07 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Brown Brothers Plumbing & Heating Co, Inc Party/Vendor Contact Person: Jeff Addison <br /> Contact Phone: 919-220-2551 Party/Vendor Address: 2820 North Roxboro Rd City Durham State: NC Zip: 27704 <br /> Department: AMS Amount: $4592.00 Purpose: Passmore cold water line repair Budget Code(s): 10240320-570000 <br /> Vendor# 35730 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) <br /> New ❑ Renewal ❑ Amendment ❑ Effective Date 12/23/2019 Approved by Board Yes❑ No❑ Agenda <br /> 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 �� "A Date:12/12/2019 <br /> 2DD9CD6681844C5. <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: <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 insu-----D-o-c„si9ppneQa_ay:.�6---ifications,and requirements: <br /> a <br /> Office of the Risk Management Officer Usa L Date: 12/16/2019 <br /> 7FDCF9176800498. <br /> Financial Services <br /> This instrument has been pre-audited in the manne Docusigned by: ovemment Budget and Fiscal Control Act: <br /> ('� 12/16/2019 <br /> Office of the Chief Financial Officer 7D4E51s,acc,4os. Date: <br /> Legal Services <br /> This agreement is approved as to legal fo DocuSigned by: <br /> �bL&I Pkk l 5 12/16/2019 <br /> Office of the County Attorney EA AM3sEDsaa4s5.. 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 11/19 4 <br />