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DocuSign Envelope ID: DB9E9CE3-77FD-4FE7-9CC4-F5FEOD9A8A81 <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: 919.667.0472 Party/Vendor Address: 3326 Durham Chapel Hill <br /> Blvd, Ste. B-100 City Durham State:NC Zip: 27707 Department: AMS Amount: $6000.Fixed fee of$5,200 for <br /> easement dedication, $800 for reimbursables Purpose: Southern Campus Expansion - Easement Dedication Plat <br /> Budget Code(s): 61370035-870000-10065 Vendor#52775 (N/A if new vendor) Vendor is a BOCC consultant? <br /> Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ❑ Amendment ❑ Effective Date 1/22/2021 <br /> 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 <br /> on this project has not been initiated prior to execution of the agreement: <br /> D 5 g by <br /> Department Director's Signature S B6ec6Q 1/24/2021 <br /> Date: <br /> �25e5i5ddc5.. <br /> Agreements for emergency services or repair are 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 <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 /> USXD s g ogby: 1/24/2021 <br /> Office of the Risk Management Office '" (,aw: Date: <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 /> DocbSig,,d by: <br /> Office of the Chief Financial Officer �" Date: 1/26/2021 <br /> �D.......... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> D 5'g g by: <br /> Office of the County Attorney J6�hniw Date: 1/26/2021 <br /> C <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 /> 9 <br />