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DocuSign Envelope ID:6F1378EE-84DB-45B0-90DE-C39BA2077B34 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Final Passage Transport Party/Vendor Contact Person: Raven Coleman Contact Phone: <br /> 919-327-0041 Party/Vendor Address: 3434 Edwards Mill Rd, Ste 112-192 City Raleigh State: NC Zip: <br /> 27612 Department: Emergency Services Amount: $Five thousand dollars Purpose: COVID-19 <br /> transportation of decedents in the event of Mass Fatality at 200.00 per transport Budget Code(s): 10750020- <br /> 63000-95020 Vendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract <br /> 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 <br /> work on this project has not been initiated prior to execution of the agreement: <br /> Ilocusigned by: <br /> Department Director's Signature Date: 4/28/2020 <br /> EV5655BC89IA64473 <br /> Agreements for emergency services or repair are not subject to the above affirmation. If services related to <br /> this agreement have already begun or been completed please briefly describe the nature of the emergency <br /> condition that was addressed: <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed <br /> and is 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 insuran,-P stnndnrd, -morifications, and requirements: <br /> Wcu5igned by: <br /> Office of the Risk Management Officer ��Sa 4/28/2020 <br /> 7F©CF917E800��49�6 Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal <br /> Control Act: oocusigned by: <br /> 41 .e.4va. 4/29/2020 <br /> Office of the Chief Financial Officer Date: <br /> —Irl7NE5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and suffix;- -cosigned by: <br /> Office of the County Attorney` � �°}"' - Date: 4/29/2020 <br /> 4035CB8304CA4Ae... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: <br /> singersoll@orangecountync.gov <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> 11 <br />