HomeMy WebLinkAboutR 2016-223-E AMS - Tibbens Construction, Inc. for Whitted Room 210 Renovation DocuSign Envelope ID: C057BFCE-FE50-48B8-990C-1588389F9587
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Tibbens Construction Inc. Party/Vendor Contact Person: Mark Tibbens Contact Phone:
919.643.2856 Party/Vendor Address: 849 Moose Tracks Trail City Cedar Grove State: NC Z_ ip: 27231
Department: AMS Amount: $14,365.00 Purpose: Whitted Room 210 Renovation Budget Code(s): 10240320-
570001 Vendor# 63556 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type:
(Check one)New ® Renewal ❑ Amendment ❑ Effective Date April 22, 2016 Approved by Board Yes❑
No® Agenda Date:
This agreement is approved as to technical form and content:
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Department Director's Signature � Date; 4/19/2016
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Information Technologies
(Applicable only to harchvare/sofhvare pao•chases 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:
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Office of the Risk Management Officer aUsa�owuf�o Date; 4/20/2016
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Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act:
DocuS,g d by.
Office of the Chief Financial Officer Date: 4/20/2016
LeLyal Services
This agreement is approved as to legal form and sufficiency:
D.—S19-d by.
Office of the County Attorney X66. r6yy Date: 4/22/2016
Cleric to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydgorangecountync.gov
The following signature block is for hard copies only and is not required for Docusign contracts:
Revised 1/16 6