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ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name : Party/Vendor Contact Person : Contact Phone : Party/Vendor <br /> Address : City . State : Zip : Department : Amount : Purpose : <br /> Budget Code (s) : Vendor # (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No ❑ <br /> Contract Type : (Check one) New ❑ Renewal ❑ Amendment ❑ Effective Date Approved by Board <br /> Yes ❑ No ❑ Agenda Date : <br /> This agreement is approved as to technical form and content : <br /> Department Director ' s Signature Date : <br /> Asset Management <br /> (Applicable only to construction contracts) This agreement has been reviewed and is approved as to <br /> construction services content and specifications : <br /> Office of the Asset Management Director Date : <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 <br /> Act : <br /> Office of the Chief Financial Officer Date : <br /> Legal Services <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 Sherri Ingersoll upon completion : singersoll@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 /> 16 <br />