HomeMy WebLinkAboutR 2014-548 AMS - Tile Restoration, Inc. for floor restoration in Whitted Building B Dental Clinic Restrooms $3,535DocuSign Envelope ID: 098EB4F2 -C3F4- 4867- B5FC- 1 14E7E9097CF
ORANGE COUNTY — DEPARTMENT USE ONLY
Department
Party/Vendor Name: Tile Restoration Inc Party /Vendor Contact Person: Brad Albritton Contact Phone: 252- 916 -2045
Party/Vendor Address: 119 East Main Street City Hookerton State: NC Zip: 28538 Department: Asset Management
Services Amount: $3,535 Purpose: floor restoration in Whitted Building B Dental Clinic Restrooms Budget Code(s):
10240520- 630000 Vendor # 61702 (N /A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract
Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 10/31/2014 Approved by Board Yes❑
No❑ Agenda Date:
This agreement is approved as to technical form and content:
DocuSigned by:
Department Director's Signature 5; no <rdlow Date: 10/31/2014
9EHOA46CF64498...
Information Technologies
(Applicable only to hardware /software purchases or related services) This agreement has been reviewed and is
approved as to information technology content and specifications:
Office of the Chief Information Officer
Risk Management
Date:
This agreement is approved for sufficiency of insurance standards, specifications, and requirements:
DocuSig d by:
Office of the Risk Management Officer a�tSa reVtn t}b Date: 10/31/2014
Financial Services
This instrument has been pre- audited in the Ana�ne� yrequired by the Local Government Budget and Fiscal Control Act:
�` R^'�^ 10/31/2014
Office of the Chief Financial Officer ���666 Date:
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Letial Services
This agreement is approved as to le a� fo ndgnd sufficiency:
Office of the County Attorney PkA Date: 10/31/2014
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Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd a,oran eg countync.g_o_v
The following signature block is for hard copies only and is not required for Docusign contracts:
DocuSigned by:
Office of the Clerk to the Board 106va&A 64W Date: 11/2/2014
7E61 B3FC087B4DE..
Revised 10/14 4