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DocuSign Envelope ID:098B7080-775F-4220-9432-FB15222455EA <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Hazen&Sawyer,P.C. Party/Vendor Contact Person: Alan Stone,P.E.,Vice President Contact <br /> Phone:919-755-8569 Party/Vendor Address:4011 West Chase Blvd.,Suite 500 City Raleigh State:NC Zip:27607 <br /> Department: Planning Amount: $2,500.00 Purpose: Initial Data Collection for On-Call Professional En ing eering <br /> Services Related to the Lake Orange Dam Emergency Action Plan(EAP) Budget Code(s): 10695020-720013 Vendor <br /> #59201 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New <br /> Renewal ❑ Amendment ❑ Effective Date May 15, 2020 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 <br /> this project has not been initiated prior to execution of the agreement: <br /> Department Director's Signature C 9�by:6� d+ct Date: 5/15/2020 <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: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards, specifications,and requirements: <br /> Office of the Risk Management OfficerEK 6..t Date: 5/15/2020 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer C Date: 5/15/2020 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Office of the County Attorney ts9 Date: <br /> 5/15/2020 <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 <br /> 9 <br />