HomeMy WebLinkAboutR 2016-135-E AMS Statler Gilfillen for Board of Elections storage upfit design DocuSign Envelope ID: C5B8B85E-6DD1-43B0-8A3D-A46835EB2CE7
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Statler Gilfillen Party/Vendor Contact Person: Statler Gilfillen Contact Phone: 919-732-6123
Party/Vendor Address: 3302 St Mary's Road City Hillsborough State: NC Zip: 27278 Department: AMS Amount:
$3650 Purpose: Bd of Electrions Storage Upfit Design Budget Code(s): 61370035-880000-10042 Vendor # 63294
(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 coldoeT�lStf igne d by:
Department Director's Signature 7 Date: 1/28/2016
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 i 79�S-O--'
(2t"ards, specifications,and requirements:
r,Orv�,c,�16 1/28/2016
Office of the Risk Management Officer 6�0498 Date:
Financial Services
This instrument has been pre-audited in the Ng-Wirgo by the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer �" `�"� Date: 1/31/2016
7D4E5181ACC1409...
Legal Services
This agreement is approved as to legal form and W fUmc,*:
Office of the County Attorney Date: 2/2/2016
EAA3D33EDSA8465...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dollod(cr�,oran eg countyac og_v
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 10/14 4