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DocuSign Envelope ID:97F7F7DE-F3DE-4C40-8A7C-AF2F2DC9D84D <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Goldberg_Segalla Party/Vendor Contact Person: David Harris Contact Phone: 336-419-4910 <br /> Party/Vendor Address: 701 Green Valley Road I Suite 310 1 Greensboro,NC 27408 City Greensboro State: NC <br /> Zip: 27408 Department: County Attorney Amount: 10,000 Purpose: Legal Consultation Budget Code(s): 630000 <br /> Vendor# (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 <br /> 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 /> P6, <br /> (a, I°bl�tyvocuSigned by: <br /> Department Director's Signature Date: 5/3/2021 <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 /> Office of the Risk Management Officer Date: <br /> 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 /> 11 <br /> Office of the Chief Financial Officer Date: 5/4/2021 <br /> Legal Services <br /> This agreement is approved as to lega asn6d�y€,iciency: <br /> Office of the County Attorney Date: 5/4/2021 <br /> Fs... <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 />