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Revised 07/20 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br /> <br />Party/Vendor Name: Summit Design and Engineering Services, PLLC Party/Vendor Contact Person: Don Dewey <br />(Don.Dewey@summitde.net) or Troy Dover (Troy.Dover@summitde.net) Contact Phone: 70919.732.3883 Party/Vendor Address: <br />320 Executive Court City Hillsborough State: NC Zip: 27278 Department: AMS Amount: $5000 to increase contract to <br />$275,238.00 Purpose: This change amendment is to increase the not to exceed amount of the existing contract for Construction <br />Materials Testing and Special Inspections Budget Code(s): 61370035-870001-10064 ($1,325) 61370035-870002-10064 ($3,675) <br />Vendor # 53403 (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New <br />Renewal Amendment Effective Date 5/5/2021 Approved by Board Yes No Agenda Date: <br /> <br />This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has <br />not been initiated prior to execution of the agreement: <br /> <br /> <br />Department Director’s Signature ________________________________________ Date: ________ <br />Agreements for emergency services or repair are not subject to the above affirmation. If services related to this agreement h ave <br />already begun or been completed please briefly describe the nature of the emergency condition that was addressed: N/A <br /> <br />Information Technologies <br /> <br />(Applicable only to hardware/software purchases or related services) This agreement has been reviewed and is approved as to <br />information technology content and specifications: <br /> <br />Office of the Chief Information Officer___________________________________ Date: ________ <br /> <br />Risk Management <br /> <br />This agreement is approved for sufficiency of insurance standards, specifications, and requirements: <br /> <br />Office of the Risk Management Officer ___________________________________ Date: _________ <br /> <br />Financial Services <br /> <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br /> <br />Legal Services <br /> <br />This agreement is approved as to legal form and sufficiency: <br /> <br />Office of the County Attorney __________________________________________Date: ________ <br /> <br /> <br />Clerk to the Board <br /> <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 /> <br />Office of the Clerk to the Board __________________________________________Date:_________ <br />DocuSign Envelope ID: 82D0FC91-4915-4374-AEB4-BEE5F3130B47 <br />4/30/2021 <br />5/3/2021 <br />5/6/2021 <br />5/6/2021