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DocuSign Envelope ID:7249DADO-19FF-4COE-88F9-EA556OE34ED7 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Drain Express, Inc Party/Vendor Contact Person: Dickie Atkinson (drainexp(a),bellsouth.net) <br /> Contact Phone: 919-968-0070 Party/Vendor Address: PO Box 670 City Carrboro State:NC Zip: 27510 Department: <br /> AMS Amount: $1633.95 Purpose: EAC (306 Revere Road) sewer line cleanout Budget Code(s): 10240320-570000 <br /> Vendor# 60409 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) <br /> New ® Renewal ❑ Amendment ❑ Effective Date 02/07/2020 Approved by Board Yes❑ No❑ Agenda <br /> 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 /> DS <br /> UocuSigned by: <br /> Department Director's Signatu Es!= ey►n Date <br /> Agreements for emergency servic6681844C5... 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: Emergency due to facility maintenance was unable to clear the sewer line with the equipment that they had. <br /> The facility was without a toliet and sink,help was called out to fix the problem so the employees would have a <br /> working bathroom. <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 sufficiencv of insurance standards, specifications,and requirements: <br /> C91DocuSigned by: <br /> sa / , <br /> 7FDCF9176900498 <br /> UOffice of the Risk Management Offic L46Date: 3/20/2020 <br /> ... <br /> D.S <br /> r Financial Services <br /> l/ This instrument has been pre-audited i^tko usg�ea av P"i—I 1"i the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Office C 1.t�j Date:3/22/2020 <br /> 7NE5181ACC1469... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorn[� � �t <br /> 6mv, Date:3/22/2020 <br /> 4C5F3CDDF0694F6... <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 />