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DocuSign Envelope ID:484DA2FF-FF69-4942-ABE7-lC7B9FE1C133 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Brown Brothers Plumbing & Heating Party/Vendor Contact Person: Jeff Addison Contact <br /> Phone: 919-220-2554 Party/Vendor Address: PO Box 15668 City Durham State: NC Zip: 27704 Department: <br /> AMS Amount: $14,390.00 Purpose: To fix Sewer Line at the Courthouse Budget Code(s): 10240320-570000 <br /> Vendor#35730 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one) <br /> New® Renewal❑ Amendment ❑ Effective Date 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 /> DocuSigned by: <br /> Department Director's Signatu e SIB a Date: 3/11/2021 <br /> Agreements for emergency services or repair 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: <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 /> DocuSigneed""by: <br /> ''ll� <br /> Office of the Risk Management Offic�!7FDCF9176800498 <br /> &A, Chvv�.t lib Date: 3/12/2021 <br /> . <br /> DS <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Office 01. Date: 3/16/2021 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as fib emiand sufficiency: <br /> Office of the County Attorne ,^�bst L Rev' Date: 3/18/2021 <br /> ---zrcsF3C6QFaR= _ <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 />