HomeMy WebLinkAboutR 2015-470-E AMS - Advanced Sealcoating, Inc. for striping and stenciling through OC per Proposal #1077 DocuSign Envelope ID: 1 E463956-EA9F-49E5-80F3-FE5F52A5605F
ORANGE COUNTY—DEPARTMENT USE ONLY
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Department
Party/Vendor Name: Advanced Sealcoating, Inc Party/Vendor Contact Person: Dan Stark Contact Phone: 919-
844-?257 Party/Vendor Address-, 8809 Erinsbrook Drive City Raleig State: NC Zip: 27617 Department: A 1
Amount. S,5000 Purposc: S ji ing & ciling..1hroughout CSC' per Prorip 41077 Budget Codc(s): 10240320-
570000 P0 1502067 Vendor # 59959
.......... (N/A if new vendor) Vendor is a BOCC consultant? Yes [] No❑
Contract Type,: (Check one)New Z Renewal[:] Amendment F-1 Effective Date 08/24/2015 Approved by Board
Yes❑NoD Agenda Date:
This agreement is approved as to tect 8/24/2015
Department Director's Signature Date:
Information Technologies
(Applicable onh,io hardvilarelsqftware purchases or related services)This agreement has been reviewed and is
approved as to inforniation technology content.and specifications:
Office of the Chief Information t ff cer Date:
Risk Manav_emen
This agreement is approved for sufficiency of insurance standards,,specifications,and requirements:
DocuSigned by:
Office of the Risk Management Officer__ (hnuN Date: 8/25/2015
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�7FDCF9176800498...
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act: DocuSigned by:
Office of the Chief Financial Officer Date: 8/25/2015
Lc2al Services
This agreement is approved as to legal form and sufficiency:
DocuSigned by,
Office of the County Attorney �66, re,� Date: 8/25/2015
PEAA3D33ED8A8465...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donnal...,loydupon completion @ [:�)olloyd(i47oi-anp-ecotintvnc.gov
The following signature block is for hard copies only and is not required for Docusign contracts:
Revised 10/14 5
DocuSign Envelope ID: 1 E463956-EA9F-49E5-80F3-FE5F52A5605F
Office of the Clerk to the Board Date
Rcvised 110/14