HomeMy WebLinkAboutR 2016-576-E AMS - ASD (Asphalt Services On Demand) for repaving parking lot at Skills Development DocuSign Envelope ID:6EED282B-AE99-4E23-8F12-8D5CFC79F06D
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: ASD(Asphalt Services On Demand) Party/Vendor Contact Person: Tim O'Donnell (tim.o e,asdinc.net)
Contact Phone: 919.524.1979 Party/Vendor Address: 959 Short Journey City Smithfield State: NC Zip: 27577
Department: AMS Amount: NTE$100,702.50 Purpose: Skills Development Repave Parking Lot Budget Code(s): 61370035-
880000-30029 Vendor#N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check
one)New® Renewal ❑ Amendment ❑ Effective Date October 20,2016 Approved by Board Yes❑No® Agenda
Date:
This agreement is approved as to technical form and content:
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Department Director's Signature EE�� Date: 10/18/2016
Information Technologies
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(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:
Uoc 59 dby:
Office of the Risk Management Office QUsa(,awu b Date: 10/19/2016
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
Uoc 59 dby:
Office of the Chief Financial Officer Date: 10/24/2016
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Legal Services
This agreement is approved as to legal form and sufficiency:
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Office of the County Attorney �66°r6uw s Date: 10/25/2016
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydgoran eg_countmc.gov
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The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board Date:
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Revised 6/16 10