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<br />Revised 06/21 <br /> <br />10 <br /> <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br /> <br />Party/Vendor Name: Brock Contract Services, Inc. Party/Vendor Contact Person: Eric Christian <br />(echristian@brockcontract.com) Contact Phone: 919.614.8104 Party/Vendor Address: 1108 Nowell Road City Raleigh <br />State: NC Zip: 27607 Department: AMS Amount: $6,400.00 Purpose: CGCC - Repair the existing flooring Budget Code(s): <br />61370035-880000-10016 Vendor # 67470 (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract <br />Type: (Check one) New Renewal Amendment Effective Date 2/24/2023 Approved by Board Yes No <br />Agenda Date: --- For Section XIV. c. contracts 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 <br />project has not been initiated prior to execution of the agreement: <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 cond ition that was addressed: N/A <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 /> <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 /> <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 /> <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 /> <br /> <br /> <br />DocuSign Envelope ID: EE94B381-9707-4436-A0DA-0653262F2390 <br />2/20/2023 <br />2/20/2023 <br />2/20/2023