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DocuSign Envelope ID: 1700EA8E-15AC-4466-AF9D-985C85C15E55 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Riley Surveying, P.A. Party/Vendor Contact Person: Jose Torres: <br /> jtorres(&rileysurveyingpa.com Contact Phone: 919.667.0742 Party/Vendor Address: 3326 Durham Chapel Hill <br /> Blvd, Suite B-100 City Durham State: NC Zip: 27707 Department: AMS Amount: $4,550.00 Purpose: To <br /> provide topographic and utility surveying at the Justice Facility as per attached proposal. Budget Code(s): <br /> 61370035-870000-30002 Vendor# 52775 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® <br /> Contract Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date 2/26/2020 Approved by Board <br /> Yes❑No® Agenda Date:N/A <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work <br /> on this project has not been initiated prior to execution of the agreement: <br /> DocuSigned by: <br /> Department Director's Signature12DD9CD6B81844C5_.. <br /> � 9MA Date:2/24/2020 <br /> Agreements for emergency services or : oject to the above affirmation. If services related to this <br /> agreement have already begun or been completed please briefly describe the nature of the emergency condition that <br /> was addressed: N/A <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficient--zf:--uSignea ny:`� `ds, specifications,and requirements: <br /> Office of the Risk Management Officer QCt$a (4�6 Date:2/24/2020 <br /> 7FDCF0176800408... <br /> Financial Services <br /> os This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> f Act: �ocusigned by: <br /> IV. s� 3/11/2020 <br /> Office of the Chief Financial Officer � �. Date: <br /> 704E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as tc - Docusigned by: - ;iency: <br /> Office of the County Attorney m hmv, Date: 3/12/2020 <br /> 4C5FSCDDFOB94F8... <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 />