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<br /> Disaster Debris Clearance and Removal Services <br />Bid: 5266, Orange County, North Carolina <br />July 29, 2019 Page 53 <br /> <br /> <br /> <br />This Contract is between the Town of Chapel Hill and {Contractor’s Full Legal Name} for {Description of <br />Services to be Provided Under This Contract}. <br /> <br /> <br />IN WITNESS WHEREOF, the parties hereto cause this agreement to be executed in their respective names. <br /> <br /> <br />{CONTRACTOR’S FULL LEGAL NAME} <br /> <br />_______________________________ ___________________________________ <br />SIGNATURE PRINTED NAME & TITLE <br /> <br />_______________________________ ___________________________________ <br />WITNESS PRINTED NAME & TITLE <br /> <br /> <br />TOWN OF CHAPEL HILL <br /> <br />________________________________________________ <br />DEPARTMENT HEAD OR DEPUTY/TOWN MANAGER <br /> <br />________________________________________________ <br />PRINTED NAME & DEPARTMENT <br /> <br />ATTEST BY TOWN CLERK: <br /> <br />____________________________ <br />TOWN CLERK TOWN SEAL <br /> <br />Town Clerk attests date this the ______day of ___________, 20____. <br /> <br /> <br />Approved as to Form and Authorization <br /> <br />______________________________ <br />TOWN LEGAL STAFF <br /> <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal <br />Control Act. <br /> <br />_________________________________ ___________________________________ <br />FINANCE OFFICER DATE <br /> <br />DocuSign Envelope ID: 5FA4B1AC-B897-4C32-A1E4-4B4A8885A341DocuSign Envelope ID: E66BEF63-568B-4F97-8211-2EDDC90D1A2C