HomeMy WebLinkAboutR 2016-119-E AMS - Tibbens Construction for Board of Elections renovations DocuSign Envelope ID: 13936B85-84DF-43F8-8F41-517DO73AODA8
ORANGE COUNTY—DEPARTMENT I.1SE ONLY
Department
Party/Vendor Name: Tibbens Construction PartyNendor Contact Person: IN lark Tibbens Contact Phone: 919 643-
2856 PartyNendor Address: 849 Moose Tracks Trl. City Cedar Grove St,ite: NC Zip: 27231 Department: AMS
Amount: $16,600.00 Purpose: BOE Renovations Budget Code(s): 61370035-380000-10042 Vendor#63556 (N/A if
new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract T,rpe: (Check one) New ❑ Renewal ❑
Amendment ❑ Effective Date Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to technical form 9d content:
5i;uSigne by:
Department Director's Signature 74o.1,00"' Date:
9E880A46CF64498... 1/19/2016
Information Technologies
(Applicable only to hardware/software purchases or Belated 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:
Docu5ig/'ned"by:
'�.�.
Office of the Risk Management Officer Pausa, r,OV't td 6 Date:
7FDCF9176800498... 1/19/2016
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:-1/20/ 16
7D4E5181ACC1409...
Legal Services
This agreement is approved as to le foan aid sufficiency:
ocu Igoe y:
Office of the County Attorney Jb Date:
EAA3D33ED8A8465... 1120 2016
Clerk to the Board l
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecountync.gov
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board Date:
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Revised 10/14 4