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Revised 06/21 <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 Raleigh State: NC <br />Zip: 27609 Department: AMS Amount: Increase original contract by $12,000 for a total contract amount of $37,00 0 Purpose: <br />Emergency Services Warehouse Sprinkler Upgrades for High Bay Storage Budget Code(s): 61370035-870000-10068 Vendor # <br />66636 (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal <br />Amendment Effective Date 1/4/2022 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 on this pro ject 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: No work has been <br />completed for this change amendment. <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: 6A6A369F-10E0-42E6-9EA2-636A4414D70E <br />1/6/2022 <br />1/6/2022 <br />1/7/2022 <br />1/9/2022