HomeMy WebLinkAboutR 2016-536-E SW - Four Star Petroleum Services, Inc. - Amendment to Contract for removal of fuel tank DocuSign Envelope ID:28DAOOF8-4193-4AO9-B5AF-6D4761A9B655
ORANGE COUNTY---DEPARTMENT USE ONLY---HARD COPY ONLY
Department
Party/Vendor Name: Four Star Petroleum Services, Inc. Party/Vendor Contact Person: Cecil Morgan Contact
Phone: 540-691-5847 Party/Vendor Address: 1119 Beaumont Rd City Roanoke State: VA Zip:
Department: Solid Waste Amount: $44,244.03 Purpose: Construction (move of Fuel Tank) Budget Code(s):
50353030-880000 Vendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract
Type: (Check one)New ❑ Renewal ❑ Amendment ® Effective Date Approved by Board Yes❑ No
® Agenda Date:
This agreement is approved as to technical form an�1 content:
DocuSign by:
Department Director's Signature (Akso" Date:9/22/2016
6E763F604A144E2...
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 insurance standards,specifications, and requirements:
DocuSigned by:
Office of Risk Management && (,bnxffb Date: 9/22/2016
7FDCF9176800498...
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:
9/22/2016
�s °" a°'z
7D4E5181ACC1409...
Legal Services
This agreement is approved as to legal fo> n and s� fficiency:
igne y:
Office of the County Attorney
F�;Zs 15r dot, Date: 9/23/2016
328DC480549A4F5...
Clerk to the Board
Received for record retention:
Office of the Clerk to the Board Date: