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DocuSign Envelope ID: 1DC97074-B7F4-474F-9667-128FC11EC6AA <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> PartylVendor Name: Laura A. W. Phift Party/Vendor Contact Person: Sarre Contact Phone: 336-727-1969 <br /> Party/Vendor Address: 59 Park Blvd City Winston-Salem State: NC Zip: 27127 Department: DEAPR Amount: <br /> 2 750 Purpose: Preparation of historic landmark report for Eno(quaker'Cemetery Budget Code(s): 6137003 5 850000 <br /> 20011 Vendor#64790 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check <br /> one) New ® Renewal ❑ Amendment ❑ Effective Date March 20 2020 Approved by Board Yes❑ No® <br /> Agenda Date:NIA <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 Signature P� SfoudlL Date: 4/2/2020 <br /> Agreements for emergency services or repair are nc 611CFA1D507A495... s 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: <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 Managemen# <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> WcuSigned by: <br /> Office of the Risk Management Officer aUSA c4nu& Date: 4/3/2020 <br /> 7FDCF0176800408... <br /> Financial Services <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 Officer 4 Date: <br /> 4/6/2020 <br /> 7NE5181 ACC 1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorney � GS NA, Date: 4/6/2020 <br /> 328DC480549A4F5... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: snngersoll@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 11119 4 <br />