HomeMy WebLinkAboutR 2016-195-E AMS - Statler Gilfillen Architect MBA for construction admin services for modifications of the Whitted Building Rm. 210, per proposal dated 3-10-16 DocuSign Envelope ID:A933F1D1-BB8A-4AA6-BA5B-85764B946906
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Statler Gilfillen Architect MBA Party/Vendor Contact Person: Stater Gilfillen Contact Phone:
919-732-6123 Party/Vendor Address: 3302 St Mary's Road City Hillsborough State: NC Zip: 27278 Department:
AMS Amount: $500 Purpose: Mods to Whitted Room 210 Budget Code(s): 61370035-87000-10052 Vendor#63294
(N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New® Renewal
❑ Amendment ❑ Effective Date 03/28/2016 Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to technical fo5i;rBi aqd cg ptcnt:
Department Director's Signature Ao jxo°"' Date: 3/19/2016
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 insurance standards, specifications,and requirements:
IDocu5igned""by:'��
Qusa, rbrwc 6 3/21/2016
Office of the Risk Management Officer Date:
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in the manner recd ire4 by the Local Government Budget and Fiscal Control Act:
oc igne by:
Office of the Chief Financial Officer 3/23/2016
Fel�� s�oraR,�losz Date:
7D4E5181ACC1409...
Legal Services
This agreement is approved as to legal form and sufAgiQ evd'by.
�bU In,
Office of the County Attorney Date: 3/24/2016
EAA3D33ED8A8465...
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 1/16 4