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DocuSign Envelope ID:41539BC9-6CE0-4CC0-8CEF-CA16CC89F944 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Brock Contract Services, Inc. Party/Vendor Contact Person: Eric Christian <br /> (echristian(a)brockcontract.com) Contact Phone: 919.614.8104 Party/Vendor Address: 1108 Nowell Road City Raleigh <br /> State: NC Zip: 27607 Department: AMS Amount: $37,133.00 Purpose: CGCC - Repair the existing flooring Budget <br /> Code(s): 61370035-880000-10016 Vendor# 67470 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® <br /> Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 2/24/2022 Approved by Board Yes❑ No <br /> ® Agenda Date: ---For Section XIV. c.contracts only,Approved by Board in Current FY Budget Yes[—]No® <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this <br /> project has not been initiated prior to execution of the agreement: <br /> 2/23/2022 <br /> Department Director's Signature�&Vj_4" Date: <br /> occc�ses3aucs... <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: N/A <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards, specifications,and requirements: <br /> Office of the Risk Management Office aGs� Date:2/23/2022 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> —Sigk.V <br /> —4: 2/24/2022 <br /> Office of the Chief Financial Officer Date: <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> 2/24/2022 <br /> Office of the County Attorney C.7s (hm" Date: <br /> Clerk to the Board <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 /> Office of the Clerk to the Board Date: <br /> Revised 06/21 10 <br />