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DocuSign Envelope ID:A106738C-OD56-4376-8DDD-F663ODCE7962 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: 27516Chapel Hill Moving Company, Inc. Party/Vendor Contact Person: Ethan Smith <br /> (ethan(a-)chapelhillmoving com) Contact Phone: 919-929-6683 Party/Vendor Address: 7401 Rex Road Suite 104 City <br /> Chapel Hill State:NC Zip: 27516 Department: AMS Amount: $4145.43 Purpose: Move items from Orange County <br /> Skills Development on West Franklin St to SHSS, CGCC and landfill Budget Code(s): $829.09 (10400130-803000) <br /> $3316.34(10240330-803000) Vendor# 65179 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® <br /> Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date Approved by Board Yes <br /> ❑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 /> ocuSigned by: <br /> Department Director's SignatC�D <br /> - QVI A Date: 4/14/2020 <br /> oasca6a81844C5... <br /> Agreements for emergency services or repair are nuL 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 needing to move out of the office building. <br /> Information Technolouies <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 sufficier Wcusigned by: ��tt" lards,specifications,and requirements: <br /> SUS& �,bV1rt.C.[16 4/14/2020 <br /> Office of the Risk Management Offic 7FOCFs176s004ss... Date: <br /> °S Financial Services <br /> �L <br /> This instrument has been pre-audited oocuSig'nedby:__ "y the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officelr7NE5181ACCAH <br /> .t�j `� " Date:4/16/2020 <br /> . <br /> Legal Services <br /> This agreement is approved as-I---'geed by r-I —4frciency: <br /> DocuSOffice of the County AttornC?C5F3CDDF0B94F6 <br /> St�, �l.N1 v, Date: 4/16/2020 <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 />