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Revised 11/19 <br /> <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />_____________________________________________________________________________________________________ <br /> <br />Party/Vendor Name: Racanelli Construction South, Inc Party/Vendor Contact Person: Scott Drebitko (sdrebitko@racanelliconstruction.com) Contact <br />Phone: 919.363.3600 Party/Vendor Address: 1001 Pemberton Hill Road Ste 202 City Apex State: NC Zip: 27502 Department: AMS Amount: <br />$351.00 Purpose: PFAP Freezer Installation remove existing disconnects Budget Code(s): 30600030-800000-71370 Vendor # 62962 (N/A if new <br />vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date 1/25/2020 <br />Approved by Board Yes No Agenda Date: <br /> <br /> <br />This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated <br />prior to execution of the agreement: <br /> <br /> <br />Department Director’s Signature ________________________________________ Date: ________ <br />Agreements for emergency services or repair are not subject to the above affirmation. If services related to this agreement have already begun or been <br />completed please briefly describe the nature of the emergency condition that was addressed: N/A <br /> <br /> <br />Risk Management <br /> <br />This agreement is approved for sufficiency of insurance standards, specifications, and requirements: <br /> <br />Office of the Risk Management Officer___________________________________ Date: _________ <br /> <br /> <br />Financial Services <br /> <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br /> <br /> <br />Legal Services <br /> <br />This agreement is approved as to legal form and sufficiency: <br /> <br />Office of the County Attorney __________________________________________Date: ________ <br /> <br /> <br />Clerk to the Board <br /> <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 /> <br />Office of the Clerk to the Board __________________________________________Date:_________ <br /> <br /> <br />DocuSign Envelope ID: 3B5EFA61-95FF-432C-8D9C-9ECE68C8B0F7 <br /> <br /> <br /> <br />