HomeMy WebLinkAboutR 2016-683-E AMS - Tibbens Construction to replace 10' crown molding at Dickson House DocuSign Envelope ID: 5FAAAC17-D6F9-46D4-BF6E-5A937A37B47F
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 Trail City Cedar Grove State: NC Zip:
27231 Department: AMS Amount: $2.150.00 Purpose: Replace 10' crown molding at the Dickson House front
porch Budget Code(s): 10240320-570000 Vendor#63556 (N/A if new vendor) Vendor is a BOCC consultant?
Yes ❑ No[] Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 11/29/16
Approved by Board Yes❑No® Agenda Date:
This agreement is approved as to technical forth and content:
D Sg tlby.
Department Director's Signature "� Date: 12/1/2016
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 insurance standards, specifications, and requirements:
Do S g tlby.
QUSOL (hw 6 12/2/2016
Office of the Risk Management Officer Date:
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act:
D d
Office of the Chief Financial Officer 4 n� Date: 12/2/2016
Legal Services
This agreement is approved as to legal forth and sufficiency:
D S tlby.
Office of the County Attorney Date: 12/2/2016
—ENlSD33EDII1SSA6S__
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloy(d c�orangecount.nlc.gov
The following signature block is for hard copies only and is not required for Docusign contracts:
Revised 6/16 6