HomeMy WebLinkAboutR 2016-226-E AMS - FloorChem, Inc. for flooring upgrades at WHSC Bldg. B DocuSign Envelope ID:A61 DDHMC24-421313-131324-E011 DBDAAA9B
ORANGE COUNTY—DEPARTMENT USE ONLY
Deuartment
Party/Vendor Name: F1oorChem, Inc. Party/Vendor Contact Person: Anita M. Brack Contact Phone: 919-427-
1547 Party/Vendor Address: 200 Powell Drive, Ste 103 City Raleigh State: NC Zip: 27606 Department: AMS
Amount: $29,086 Purpose: flooring upgrades WHSC Bldg B Budget Code(s): 10240520-630000 Vendor# 57002
(N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New
Renewal ❑ Amendment ❑ Effective Date 04/21/2016 Approved by Board Yes❑ No❑ Agenda Date:
This agreement is approved as to technical form and content:
Fi;uSig ned by:Department Director's Signature �O"`7�Of' Date: 4/19/2016
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 insurqpce st a�gyards, specifications, and requirements:
Office of the Risk Management Officer F,usa, rb�6 Date: 4/21/2016
7FDCF917 1800498...
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: 4/25/2016
('� �osr�2osz
7D4E5181ACC1409...
Legal Services
This agreement is approved as to legal form and sufficiency: .
uSigne by.,'�L,
Office of the County Attorney
56Z, r6ufs Date: 4/26/2016
EAA3D33EDM8465...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloydL�oranaecountync.Qov
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
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