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DocuSign Envelope ID : DC812C3D-BEF3 -4DF1 -9A31 -4F7BBA72DCFD <br /> i <br /> i <br /> ORANGE COUNTY- DEPARTMENT USE ONLY <br /> 1 <br /> i <br /> Party/Vendor Name : The Preservation Fund of Hillsborough , Inc . Party/Vendor Contact Person : Patricia Revels <br /> Contact Phone ; 5024324662 Party/Vendor Address : 329 West King Street City Hillsborou>h State : NC Zip : 27278 <br /> Department; DEAPR Amount; Revenue to County : $ 100 per year Purpose : Lease of Property Budget Code (s) : N/A <br /> Vendor # N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No X Contract Type ; (Check one) <br /> New X Renewal ❑ Amendment ❑ Effective Date November 1 , 2021 Approved by Board Yes X No ❑ Agenda <br /> Date : October 19 , 2021 -- - For Section XIV . c . contracts only, Approved by Board in Current FY Budget Yes ❑ No <br /> El <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work on r <br /> this project has not been initiated prior to execution of the agreement : <br /> DocuSignedd by: <br /> Department Director ' s Signature �� � AAA Date : 11/ 30 / 2021 <br /> Agreements for emergency services or repair are bjwpt ". above affirmation. If services related to this I <br /> agreement have already begun or been completed please briefly describe the nature of the emergency condition that <br /> was addressed : <br /> Information Technolo ies <br /> i <br /> A Ilcable only to hardware/software purchases or related services) This agreement has been reviewed and is <br /> ( PP Y <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 /> DocuSigned"by: <br /> Qusx (brvu,ttb 11/ 30 / 2021 <br /> Office of the Risk Management Officer Date : <br /> 7FDCF9176800498.. . i <br /> i <br /> Financial Services <br /> This instrument has been pre- audited in the manner required by the Local Government Budget and Fiscal Control Act : <br /> DocuSigned by: } <br /> Office of the Chief Financial Officer Date : 11/ 30 / 2021 <br /> k �L7NE5181ACC1409. . . <br /> E <br /> Legal Services <br /> i C <br /> c <br /> This agreement is approved as to legal form and sufficiency :. <br /> DocuSigned by: <br /> � <br /> Office of the County Attorney a►MLS �jV Alit, Date ; 11/ 30 / 2021 <br /> 328DC480549A4F5. .4 <br /> a <br /> Cleric to the Board <br /> G , <br /> Received for record retention : <br /> All Docusign contracts must be copied to the Cleric upon completion : occlerkdocs@orangecountyne . 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 : ; L <br /> 1 <br /> Revised 06/21 <br />