HomeMy WebLinkAboutR 2015-604-E AMS - Carolina Earthscapes, Inc. to install pad and ramp for library book drop box DocuSign Envelope ID: B6987D02-4EBE-4456-8ABA-AC4410CD3B93
ORANGE COUNTY-DEPARTMENT USE ONLY GD
Department
Party/Vendor Name: Carolina Earthscapes Inc. Party/Vendor Contact Person: David Fletcher Contact Phone:919-
730-5373 Party/Vendor Address: 1841 North HWY 119 City Mebane State: NC Zip: 27302 Department: Asset
Management Services Amount: $2,830 Purpose: Install pad and ramp for library book drop box Budget Code(s):
10240320-570001 Vendor 4 63117 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract
Type: (Check one)New ® Renewal❑ Amendment ❑ Effective Date 11/04/2015 Approved by Board Yes❑
No® Agenda Date:N/A
This agreement is approved as to technical form and content:
5y;uSigned by:
Department Director's Signature �OfN? Date: 11/14/2015
9E880A46CF64498...
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 Date:
Risk Management
This agreement is approved for sufficiency of insurance standards,specifications,and requirements:
DocuSigned""by:
''111L
Office of the Risk Management Officer EMS& 66vvt,e 6 Date: 11/17/2015
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act: ocuSigned by:
Office of the Chief Financial Officer 4N � Date: 11/19/2015
L�D 4E5181ACC1409...
Legal Services
This agreement is approved as to legal form and rDj.4 1ymd by:
Office of the County Attorney rokwfs Date: 11/20/2015
EAA3D33EDSA8465...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloai.oran ecoun nc.
The following signature block is for hard copies only and is not required for Docusign contracts:
Revised 10/14 5
DocuSign Envelope ID: B6987D02-4EBE-4456-8ABA-AC4410CD3B93
Office of the Clerk to the Board Date:
Revised 10/14 6