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DocuSign Envelope ID: F202BA43-FFBB-479D-A3DC-3F53200045DB <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Gonzalez Painters & Contractors.Ane Party/Vendor Contact Person: Hector Javier Rivera <br /> Contact Phone: 919-702-5510 Party/Vendor Address: 4341 Bennett Memorial Road City Durham State: NC Zip: <br /> 27705 Department: AMS Amount: Not to exceed (Twenty Three Hundred Dollars 2300.00 Purpose: Interior <br /> painting of Historic Court House in Court Room Budget Code(s): 10240320-570000 Vendor # 61921 (NIA if new <br /> vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New M Renewal ❑ <br /> Amendment ❑ Effective Date 02/05/2020 Approved by Board Yesn NoM 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 /> Docusigned by: <br /> Department Director's Signat si= QIM A Date: <br /> Agreements for emergency servi sDD9CDae81844C5... 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: NA <br /> Information Technologies <br /> (applicable only to hardwarelsoftware 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 Mana-zement <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> DocuSigned by: <br /> Office of the Risk Management Of ausa C6W_&6 Date: <br /> Dg 7FDCF9176900498... <br /> �7L Financial Services j <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Off Date: <br /> 704E5981ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Docu Signed by: <br /> Office of the County Attor C?C5F3CDDF0B94F6 <br /> %f!_ hmv, Date: <br /> ... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@orangecountyne.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 I1/19 4 <br />