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DocuSign Envelope ID:4FE3lF34-3D59-4065-92CD-929B08ACFEE8 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Riley Surveying, P.A. Party/Vendor Contact Person: Jose Torres <br /> (itorres@rileysurveyingpa.com) Contact Phone: 919.667.0742 Party/Vendor Address: 3326 Durham Chapel Hill <br /> Blvd. Ste B-100 City Durham State: NC Zip: 27707 Department: AMS Amount: $5500.00 (Fixed fee of$5200 <br /> and$300 for Reimbursables) Purpose: Whitted Building Complex Storm/Sewer Route Camera Inspection Budget <br /> Code(s): 61370035-870000-10028 Vendor#52775 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ <br /> No® Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 4/27/2020 Approved by <br /> Board Yes❑No® Agenda Date: <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 /> Department Director's Signature 5s z QF.,,,k Date:4/23/2020 <br /> Agreements for emergency services not 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 <br /> was addressed: N/A-No work has been completed. <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 /> Office of the Risk Management Officer Qt s� �es�n�#fa Date:4/23/2020 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> P[ Act: <br /> Office of the Chief Financial Officer A 4 Date: 4/24/2020 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Office of the County Attorney �� Date: 4/2 s/2020 <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 />