HomeMy WebLinkAboutR 2016-110-E AMS - Tile Restoration, Inc. for floor restoration in multiple facilities DocuSign Envelope ID:07BFB95E-8BDF-4FA6-BB33-1D1B1EEA787C
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Tile Restoration, Inc Party/Vendor Contact Person: Brad Albritton Contact Phone: 866-327-
4600 Party/Vendor Address: PO Box 160, 119 East Main Street City Hookerton State: NC Zip: 28538 Department:
AMS Amount: $7760 Purpose: Floor restoration in multiple facilities 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 Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to technical form and content:
DocuSigned by:
Department Director's Signature Y.# Date: 1/8/2016
9E880A46CF64498...
Information Technolosies
(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:
''11i1
Office of the Risk Management Officer 9 �,Orvu X16 Date: 1/11/2016
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in the usigqui4ed by the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer 7 Date: 1/13/2016
7D4E 181ACC1409...
Legal Services
This agreement is approved as to legal form ad s�ffiS� ency:
ocu igne y:
Office of the County Attorney 56, �� Date: 1/13/2016
EAAMKEDM8465...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloy(d c�orangecount.nic.Rov
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board Date:
Revised 1/16 4