HomeMy WebLinkAboutR 2016-292-E AMS - FloorChem, Inc. for flooring upgrades at motor pool DocuSign Envelope ID: C269DO8B-F3B7-4EA6-BDAO-2DE5B421 F45A
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: F1oorChem Inc Party/Vendor Contact Person: Anita M. Brack,Owner Contact Phone: 919-854-
9776 Party/Vendor Address: 200 Powell Drive, Ste 103 City Raleigh State: NC Zip: 27606 Department: AMS
Amount: $4902 Purpose: Flooring upgrades at Motor Pool 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 06/09/2016 Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to technical to Wgyt:
Department Director's Signature Ye# Ao or, Date: 6/8/2016
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 in bWMWA dards, specifications,and requirements:
Office of the Risk Management Officer Qusa, (hntt N Date: 6/8/2016
7FDCF91 6800498...
Financial Services
This instrument has been pre-audited in the manner%%jired by the Local Government Budget and Fiscal Control Act:
u ig ed by:
6/11/2016
Office of the Chief Financial Officer F�0!c
Date:
7D4E5181ACC1409...
Legal Services
This agreement is approved as to legal form &AW..:
Office of the County Attorney �b- r6ufs Date: 6/13/2016
EAA3D33ED8A8465...
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