Orange County NC Website
DocuSign Envelope ID: ED6FF2DD-02CB-4F05-B8F6-FF36E16E1598 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Summit Design and Engineering Services, PLLC Party/Vendor Contact Person: Don Dewey <br /> (Don.Dewey(&,summitde.net) or Troy Dover (Troy.Dover(a)summitde.net) Contact Phone: 70919.732.3883 Party/Vendor Address: <br /> 320 Executive Court City Hillsborough State: NC Zip: 27278 Department: AMS Amount: $5000 to increase contract to <br /> $270,238.00 Purpose: This change amendment is to increase the not to exceed amount of the existing contract for Construction <br /> Materials Testingand nd Special Inspections Budget Code(s): 61370035-870001-10064 ($1,325) 61370035-870002-10064 ($3,675) <br /> Vendor # 53403 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ❑ <br /> Renewal❑ Amendment ® Effective Date 1/8/2021 Approved by Board Yes❑No® Agenda Date: <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has <br /> not been initiated prior to execution of the agreement: <br /> D Sg tlby: <br /> Department Director's Signature Sf�a" 1/7/2021 <br /> Date: <br /> —.----xDDgcogertmai-ac3_. <br /> Agreements for emergency services or repair are not subject to the above affirmation. If services related to this agreement have <br /> already begun or been completed please briefly describe the nature of the emergency condition that was addressed: N/A <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is approved as to <br /> information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> D Sig etl by: <br /> Office of the Risk Management Office aGsa(,an'u,$e Date:11712021 <br /> Financial Services <br /> S This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> �V D Sig tl by: <br /> Office of the Chief Financial Officer L 0—.& ` Date:1/9/2021 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> D Sig—by: <br /> Office of the County Attorne 6%rc .kniv, Date:1/11/2021 <br /> Clerk to the Board <br /> Received for record retention: <br /> All DocuSign contracts must be copied to the Clerk upon completion: occlerkdocs@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 07/20 <br />