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DocuSign Envelope ID: EOD035CF-BC7E-4E6F-8A43-79902D1DE39E <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: 27516Chapel Hill Moving Company, Inc. Party/Vendor Contact Person: Ethan Smith <br /> (ethana,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: $4180.00 Purpose: Move items from Cedar Grove, <br /> Whiffed, Hillsborough Commons, West Campus, Southern to Europa Budget Code(s): (80%) 10240330-803000 <br /> $3344.00 (20%) 10400130-803000 $836.00 Vendor#65179 (N/A if new vendor) Vendor is a BOCC consultant? <br /> Yes ❑No® Contract Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date 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 on <br /> this project has not been initiated prior to execution of the agreement: <br /> DLLocu��S��igned by: <br /> Department Director's Signat reS Wt, AMA Date: 1/13/2021 <br /> Agreements for emergency servic 6PWAT1Af hot 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: <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 /> DocuSigned""by: <br /> ''ll� <br /> Office of the Risk Management Offic r USA, rbvv�.c,TTb Date: 1/14/2021 <br /> 7FDCF9176800498... <br /> DS <br /> pF Financial Services <br /> ff This instrument has been pre-auditedb, ,r required by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Offi e� Date: 1/14/2021 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved a begalgfom:and sufficiency: <br /> Office of the County Attor S L � mt& 1/14/2021 <br /> Zy1b Date: <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 />