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DocuSign Envelope ID:9E76CCCF-2564-4499-A1CA-43EC4ECE13EB <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Riley Surveying, PA Party/Vendor Contact Person: Jose Torres <br /> (itorres(&rileysurveyingpa.com) Contact Phone: 919-667-0742 Party/Vendor Address: 3326 Durham Chapel Hill <br /> Blvd, Suite B-100 City Durham State: NC Zip: 27707 Department: AMS Amount: $8600.00 Purpose: <br /> Boundary/Physical Survey at Builders I' Source at 401 Valley Forge Rd Budget Code(s): 10240320-630000 <br /> Vendor#52775 (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 SignatuCe�sfwtl Art" � Date: 4/21/2021 <br /> Agreements for emergency servic4@i@ti"6t 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 /> uigneed""by, <br /> ''ll� <br /> Office of the Risk Management OffiCer�SA"_Date: 4/22/2021 <br /> CF9176800498... <br /> r DS Financial Services <br /> This instrument has been pre audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: DocuSigned by: <br /> Office of the Chief Financial Offi r(A Date: 4/27/2021 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as tor <br /> r <br /> uOffice of the County Attorneyt ph, �t VVYIn, Date: 4/28/2021 <br /> 5F3CDDF0B94F6... <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 />