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DocuSign Envelope ID:55FC71AC-8COB-4B77-97F2-3B9D568AE146 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: BIRS, Inc Party/Vendor Contact Person: Mike McClure Contact Phone: 336-574-3060 <br /> Party/Vendor Address: PO Box 36197 City Greensboro State:NC Zip: 27416-6197 Department: AMS Amount:Not <br /> to exceed (One Thousand Four Hundred One Dollar and Seventy Cents) $1401.70 Purpose: Repair roof leak near <br /> chimney at the Historic Courthouse (100 East King Street) Budget Code(s): 10240320-570000 Vendor# 57369 (N/A <br /> if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ <br /> Amendment ❑ Effective Date 02/28/2020 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 /> DocuSigned by: <br /> Department Director's Signa fwt �y� Date:3/4/2020 <br /> Agreements for emergency sen 2D❑9C❑6B81844C5... it 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: Any roof leaks are considered an emergency per Asset Management Services. Repair roof leak on tin roof <br /> near chimneys at the Historic Courthouse(100 East King Street)Invoice#31641 BIRS Job#15-6408 <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 /> Wcu5igppned_by: <br /> .�t <br /> Office of the Risk Management OM aUsa LQ 6 Date:3/10/2020 <br /> DS 7FDCF9176900498... <br /> Financial Services <br /> This instrument has been pre-audited in the—nner rPn„irPd by the Local Government Budget and Fiscal Control Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Offi `� � Date3/10/2020 <br /> 7NE5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorn14C5F3CDDFOB94F6 <br /> 6%f , �l.Vl v, Date: 3/10/2020 <br /> ... <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 />