HomeMy WebLinkAboutR 2016-504-E AMS - Tibbens Construction for CGCC upgrade window DocuSign Envelope ID: E8CB95E7-533C-49AF-92F5-8C9FC602256D
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Tibbens Construction Party/Vendor Contact Person: Mark Tibbens tibbensconst@aol.com
Contact Phone: 919.667.5366 Party/Vendor Address: 849 Moose Tracks Trl. City Cedar Grove State:NC Zip: 27231
Department: AMS Amount: 790.00 Purpose: CGCC Upgrade Window Budget Code(s): 61370035-880000-10016
Vendor# 63556 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)
New® Renewal❑ Amendment ❑ Effective Date June 10, 2016 Approved by Board Yes❑ No® Agenda
Date:
This agreement is approved as to technical form and content:
Department Director's Signature Date: Q�
Information Technologies
(Applicable only to harchvare/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 insurance standards, specifications,and requirements:
Uoc 9 dby:
Office of the Risk Management Office ZS 5(,awu.flo Date: 6/8/2016
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
Uoc 5'9 dby:
Office of the Chief Financial Officer Date: 8/25/2016
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney[°(ti 9�ohwts Date: 8/25/2016
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecogElync.gov
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 6/16 4