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DocuSign Envelope ID:82EFC9DB-7D47-4E7B-9162-C9CE62D9862C <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Pine Shore Energy LLC Party/Vendor Contact Person: David Thompson, Contact Phone: <br /> 336-893-6213 Party/Vendor Address: 131 Fayette St. City Winston-Salem State: NC Zip: 27101 Department: <br /> Asset Management Services Amount: $89,335.07 Purpose: Grant-funded electric vehicle charging station <br /> replacements. Budget Code(s): 30240030-800000-71321 Vendor # 65135 (N/A if new vendor) Vendor is a <br /> BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective <br /> Date February 18th,2020 Approved by Board Yes®No❑ Agenda Date: September 3,2019 <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work <br /> on this project has not been initiated prior to execution of the agreement: <br /> DocuSigned by: <br /> Department Director's Signature Date: 2/20/2020 <br /> Agreements for emergency services or o6wtiotbj.ect 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 <br /> was 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 insurance standards,specifications,and requirements: <br /> DocuSigned"by: <br /> ' <br /> Office of the Risk Management Officerriusa, r,OV1n t . Date: 2/20/2020 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Officer F0,., Date: 2/20/2020 <br /> 7NE5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorney 5� Date: 2/24/2020 <br /> 4C5F3CDDF0B94F6... <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 <br /> 9 <br />