HomeMy WebLinkAboutR 2016-271-E DEAPR - JV Brockwell Trucking to replenish playground safety surfacing 000wSWn Envelope ID:0r8A1513-C801-48 000AE0
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
PoUy/VuudorNumu: JV Brockwell Trucking Pad}NexdorCouinct P000u: Chuck Smith Contact Phone: (919)912-
3001 PmrtylVeudorAddoau: 8821 Old NC96 City Chapel N§K State:NC Zip:27516 Dupunmnut: DiAl�R Amount:
$2,800.00 Purpose: Code(s): 10515020 630000 Vendor#42666
if new vendor) Vendor is n BUCC consultant? Yes Fl lWoM Contract Type: (Check one) New M Ruuenn| [�
/\mond/nmU 0 Effective Date 5/2312016 Approved byBoard Yem[]Nom Agenda Date:
____
Thin agreement imwpprovrdnom0ochnioa| 0onnnudcmn\uN:
o"cu»mned^':
Department Director's Signature Bu|o:______
luformation Technologies
(Applicable md),/vAm/h*m,6xqj6xnn purchases o/related services)This agreement has been reviewed and ix
approved mn<ninformation technology couiuut and specifications:
Office of the Chief Information Officer Iate:_____
Risk Mariageumit
This agreement iu approved for sufficiency oyinaomnoostandards,specifications,and requirements:
o"cumoned»,:
Office of the Risk Management Oyncx Pausa, Dm<*:_______
Financial Services
This instrUrnCut has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
m="mn"*»,:
Office oK the Chief FtuuoolaAOfficer Date:________
Legal Services
This agreement |u approved ast legal fo J sufficiencyocu D Signed by:K}�NcnoK the Comity/�ttnrmm :______
Clerk to the Board
Demc|vcd for record retention:
All DocuniQn contracts must bc copied to Donna Lloyd upon completion @
The following signature block is for hard copies only and is not required for Docusign contracts:
Office oC the Clerk to the Board Dotu:_______
Revised 1/16