HomeMy WebLinkAboutR 2016-204-E AMS - Tile Restoration Inc. to saniglaze restrooms 114 and 115 at Cedar Grove DocuSign Envelope ID: BDD226D4-62AD-40CB-ACDA-B1D18954D81A
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: 119 East Main Street City Hookerton State: NC Zip: 28538 Department: AMS Amount:
$3450 Purpose: Cedar Grove SaniGLAZE Restrooms 114 and 115 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 04/11/2016 Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to technical form ed by:
Department Director's Signature
Date: 4/8/2016
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 i � i Wds, specifications,and requirements:
Office of the Risk Management Officer Q�SA �,Orv�u16 Date: 4/8/2016
7FDCF91 6800498...
Financial Services
This instrument has been pre-audited in the ma tg6g'X&O,,py the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer Date: 11/5/15
7D4E5181ACC1409...
Legal Services
This agreement is approved as to legal form anWj6jqw�y.
Office of the County Attorney ,66, r6u s Date: 4/11/2016
EAA3D33EDSA8465...
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