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Revised 06/21 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br /> <br />Party/Vendor Name: Alpha and Omega Group, PC Party/Vendor Contact Person: Ted L. Bartelt. P.E. (President) Contact Phone: <br />919-981-0310 Party/Vendor Address: 4601 Lake Boone Trail, Suite 3C City Raleigh State: NC Zip: 27607 Department: Planning <br />Amount: $4,185.00 Purpose: Contract Amendment #3: - Lake Orange Dam – Erosion Control (EC) Barrier Design Budget Code(s): <br />61370035-870000-10074 (Lake Orange Dam Rehabilitation CIP – Professional Services) Vendor # 64223 (N/A if new vendor) <br />Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date <br />August 17, 2021 Approved by Board Yes No Agenda Date: --- For Section XIV. c. contracts only, Approved by Board in <br />Current FY Budget Yes No <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 have <br />already begun or been completed please briefly describe the nature of the emergency condition that was addressed: <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 />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: CD3EB451-5A06-4460-9B63-D70D9212E511 <br />8/19/2021 <br />8/19/2021 <br />8/19/2021 <br />8/19/2021