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Home My WebLink About2025-654-E-DEAPR-Circular Design Construction-To provide signature to form 8283 by IRS requirment to acknowledge the donationAttachmentDepartment of the Treasury Sequence No.Internal Revenue Service If donated property is a vehicle, check the box. Also enter the vehicle identification number (unless Form 1098-C is attached) Date of the Date acquired How acquired Donor's cost or Fair market value Method used to determine the fairmarket valuecontributionby donor (mo., yr.)by donor adjusted basis (see instructions) If any tangible personal property or real property was donated, give a briefsummary of the overall physical condition of the property at the time of the gift 419931 04-01-24 OMB. No. 1545-0074 (Rev. December 2023) Form Identifying number Note: Section A.Donated Property of $5,000 or Less and Publicly Traded Securities - only (b)(c)(a)1 A B C D Note: (d)(e)(g)(i)(f)(h) A B C D Section B.Donated Property Over $5,000 (Except Publicly Traded Securities, Vehicles, Intellectual Property or Inventory Reportable in Section A) - Information on Donated Property 2 a b c d e f g h i j k l b(1) 3 (b)(a)(c) A B C (d)(e)(f)(g)(h) (i) A B C For Paperwork Reduction Act Notice, see separate instructions.8283 Attach one or more Forms 8283 to your tax return if you claimed a total deduction of over $500 for all contributed property. Go to www.irs.gov/Form8283 for instructions and the latest information. Name(s) shown on your income tax return Enter the entity name and identifying number from the tax return where the noncash charitable contribution was originally reported, if different from above. Name:Identifying number: Check this box if a family pass-through entity made the noncash charitable contribution. See instructions Figure the amount of your contribution deduction before completing this form. See your tax return instructions. List in this section an item (or a group of similar items) for which you claimed a deduction of $5,000 or less. Also list publicly traded securities and certain other property even if the deduction is more than $5,000. If you need more space, attach a statement. See instructions. Description and condition of donated property(For a vehicle, enter the year, make, model, and mileage.For securities and other property, see instructions.) Name and address of the donee organization If the amount you claimed as a deduction for an item is $500 or less, you do not have to complete columns (e), (f), and (g). Complete this section for one item (or a group of similar items) for which you claimed a deduction of more than $5,000 per item or group (except contributions reportable in Section A). Provide a separate form for each item donated unless it is part of a group of similar items. A qualified appraisal is required for items reportable in Section B and in certain cases must be attached. See instructions. Check the box that describes the type of property donated. See instructions for definitions. Art* (contribution of $20,000 or more)Other real estate Vehicles Clothing and household items Digital assets Qualified conservation contribution Equipment Certified historic structure Securities NPS #Collectibles Other Art* (contribution of less than $20,000)Intellectual property Description of donated property (if you needmore space, attach a separate statement)Appraised fair market value Dateacquired bydonor(mo., yr.) How acquiredby donor Donor's cost oradjusted basis For bargain sales,enter amountreceived Qualifiedconservation contributionrelevant basis(see instructions) Amount claimedas a deduction(see instructions) Form (Rev. 12-2023) LHA 155 Part I Noncash Charitable Contributions8283 JODI S. BAKST & CORNELIS N. RADEMAKER 296-70-6222 X CONSERVATION EASEMENT AS AS DESCRIBED IN THE ATTACHED DESCRIBED IN ATTACHED DEED DOCUMENTS 95,000. 08/21 PURCHASE 40,162.0.95,000.0. CIRCULAR DESIGN CONSTRUCTION LLC (SMLLC)86-3083736 Authentisign ID: 3806C182-C8A2-F011-8E61-002248330C80Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Address (number, street, and room or suite no.)City or town, state, and ZIP code I declare that I am not the donor, the donee, a party to the transaction in which the donor acquired the property, employed by, or related to any of the foregoing persons, or married to any person who isrelated to any of the foregoing persons. And, if regularly used by the donor, donee, or party to the transaction, I performed the majority of my appraisals during my tax year for other persons. Also, I declare that I perform appraisals on a regular basis; and that because of my qualifications as described in the appraisal, I am qualified to make appraisals of the type of property being valued. Icertify that the appraisal fees were not based on a percentage of the appraised property value. Furthermore, I understand that a false or fraudulent overstatement of the property value as described in thequalified appraisal or this Form 8283 may subject me to the penalty under section 6701(a) (aiding and abetting the understatement of tax liability). I understand that my appraisal will be used in connectionwith a return or claim for refund. I also understand that, if there is a substantial or gross valuation misstatement of the value of the property claimed on the return or claim for refund that is based on myappraisal, I may be subject to a penalty under section 6695A of the Internal Revenue Code, as well as other applicable penalties. I affirm that I have not been at any time in the three-year period ending onthe date of the appraisal barred from presenting evidence or testimony before the Department of the Treasury or the Internal Revenue Service pursuant to 31 U.S.C. 330(c). Appraiser signature Appraiser name Date Title Business address (including room or suite no.) City or town, state, and ZIP code 419932 04-01-24 2 Identifying number Partial Interests and Restricted Use Property (Other Than Qualified Conservation Contributions) - 4 a (1)b (2) c d e Yes No 5 a b c Taxpayer (Donor) Statement - Declaration of Appraiser - Identifying number Donee Acknowledgment - Form 8282, Yes No Employer identification number 8283 Form 8283 (Rev. 12-2023)Page Name(s) shown on your income tax return Complete lines 4a through 4e if you gave less than an entire interest in a property listed in Section B, Part I. Complete lines 5a through 5c if conditions were placed on a contribution listed in Section B, Part I; alsoattach the required statement. See instructions. Enter the letter from Section B, Part I that identifies the property for which you gave less than an entire interest If Section B, Part II applies to more than one property, attach a separate statement. Total amount claimed as a deduction for the property listed in Section B, Part I: For this tax year ~~~~~ For any prior tax years ~~ Name and address of each organization to which any such contribution was made in a prior year (complete only if different from the donee organization in Section B, Part V, below): Name of charitable organization (donee) For tangible property, enter the place where the property is located or kept Name of any person, other than the donee organization, having actual possession of the property Is there a restriction, either temporary or permanent, on the donee's right to use or dispose of the donated property?~~~~~~~~~~~~ Did you give to anyone (other than the donee organization or another organization participating with the donee organization in cooperative fundraising) the right to the income from the donated property or to the possession of the property, including the right to vote donated securities, to acquire the property by purchase or otherwise, or to designate the person having such income, possession, or right to acquire?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Is there a restriction limiting the donated property for a particular use? List each item included in Section B, Part I above that the appraisal identifies as having a value of $500 or less. See instructions. I declare that the following item(s) included in Section B, Part I above has to the best of my knowledge and belief an appraised value of not more than $500 (per item). Enter identifying letter from Section B, Part I and describe the specific item. See instructions. DateSignature of taxpayer (donor) See instructions. See instructions. This charitable organization acknowledges that it is a qualified organization under section 170(c) and that it received the donated property as described in Section B, Part I, above on the following date Furthermore, this organization affirms that in the event it sells, exchanges, or otherwise disposes of the property described in Section B, Part I (or any portion thereof) within 3 years after the date of receipt, it will file Donee Information Return, with the IRS and give the donor a copy of that form. This acknowledgment does not represent agreement with the claimed fair market value. Does the organization intend to use the property for an unrelated use?~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ Name of charitable organization (donee) Address (number, street, and room or suite no.)City or town, state, and ZIP code Authorized signature Title Date Form (Rev. 12-2023) Part II Part III Part IV Sign Here Part V JODI S. BAKST & CORNELIS N. RADEMAKER 296-70-6222 ORANGE COUNTY GOVERNMENT 12/31/24 56-6000327 1020 US HWY 70 W PO BOX 3157 CARY, NC 27519 HILLSBOROUGH, NC 27278 EVERETT V KNIGHT Authentisign ID: 3806C182-C8A2-F011-8E61-002248330C80Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 County Manager 10/28/2025 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 Revised 01/24 1 ORANGE COUNTY—INTERNAL USE ONLY ______________________________________________________________________________ Finance Information Vendor Name: Circular Design Construction LLC Vendor Contact Person: Jodi Bakst and Cornelius Rademaker Phone: 919-697-5014 Address: 112 Emerywood Pl City Chapel Hill State: NC Zip: 27516-8718 Department: DEAPR Amount: N/A Purpose: To provide signature to Form 8283 by IRS requirement to acknowledge the donation of a conservation easement upon property owned by Circular Design Construction LLC Budget Code(s): N/A Vendor # N/A Vendor Status with NCSOS: N/A Vendor is a BOCC consultant: Yes No Contract Details Contract Type: New Amendment (Original Contract: ) (Most Recent Amendment ) Effective Date End Date Notice Date (Notice Purpose ) Award Approved by Board (Agenda Date: ); Made or Administered by Signature Authority - BOCC Express Delegation (Agenda Date: Nov. 7, 2024) - Policy 9.4: Under $5,000; Service Under $90,000; Construction Under $250,000 - Budget Policy Section XV (Capital Improvement Project: ) Bidding Informal Bidding ($30k-$90k); Formal RFP ($90k+); Other (<$30k); Exception(# ) Department Affirmation This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated prior to execution of the agreement. This agreement is approved as to technical form and content . Services related to this agreement have already begun or been completed. Description of the nature of the emergency condition that was addressed: Department Director’s Signature ________________________________________ Date: ________ Information Technologies This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer___________________________________ Date: ________ Inapplicable because no hardware/software purchases or related services Risk Management This agreement is approved for sufficiency of insurance standards, specifications, and requirements: Office of the Risk Management Officer___________________________________ Date: _________ Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer ____________________________________ Date: _________ Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney __________________________________________Date: ________ Clerk to the Board All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Received for record retention: Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575 10/13/2025 10/14/2025 10/15/2025 10/28/2025 Revised 01/24 2 Office of the Clerk to the Board __________________________________________Date:_________ Docusign Envelope ID: 22497106-C86C-4810-AA3E-8EE2C4548575