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Revised 06/21 <br />9 <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br /> <br />Party/Vendor Name: SALAS O'BRIEN North Carolina, Inc. Party/Vendor Contact Person: Adam Spach <br />(adam.spach@salasobrien.com) Contact Phone: 919.383.8118 Party/Vendor Address: 1620 Midtown Place City <br />Raleigh State: NC Zip: 27609 Department: AMS Amount: $25,000.00 Purpose: PNW ES Warehouse Mechanical <br />and Electrical Design for HVAC Budget Code(s): 61370035-870000-10068 Vendor # 66636 (N/A if new vendor) <br />Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment <br />Effective Date 9/9/2021 Approved by Board Yes No Agenda Date: --- For Section XIV. c. contracts <br />only, Approved by Board in 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 <br />on this project has not been initiated prior to execution of the agreement: <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 <br />agreement have already begun or been completed please briefly describe the nature of the emergency condition that <br />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 <br />approved as to 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 <br />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 /> <br /> <br /> <br /> <br />DocuSign Envelope ID: 15A84315-697D-4EA0-8D7D-002E59674239 <br />9/10/2021 <br />9/10/2021 <br />9/13/2021 <br />9/13/2021