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DocuSign Envelope ID:98CAB32E-1814-4C97-B61E-B14BE79B81EA <br /> ORANGE COUNTY DEPARTMENT USE ONLY <br /> Party/Vendor Name: Party/Vendor Contact Person: Contact Phone: Party/Vendor Address. City <br /> State: Zip: Department: Amount: Purpose: Budget Code(s): _ Vendor �1 <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal <br /> ❑ Amendment ❑ Effective Date Approved by Board Yes❑ No❑ Agenda Date: --- For Section XIV c <br /> contracts only,Approved by Board in Current FY Budget Ycs❑No❑ <br /> This agreement is approved as to technical form and content and 1 as Department Director affirmatively state work on this <br /> project has not been initiated prior to execution of the agreement: <br /> Department Director's Signature Datc: <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 /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> Office of the Risk Management Officer Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act. <br /> Office of the Chief Financial Officer Date: <br /> Legal Ser,.ices <br /> This agreement is approved as to legal form and sufficiency. <br /> Office of the County Attorney Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs(worangecountync.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 <br />