HomeMy WebLinkAboutR 2016-689-E AMS - 5th Wall Building Diagnostic Consultants for gutter repairs at Dickson House DocuSign Envelope ID: 15DD2190-46C0-4772-9B3A-17E98BAC1E66
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: 51' Wall Building Diagnostic Consultants Party/Vendor Contact Person: Jeff Spady
(5thwall&bellsouth.net) Contact Phone: 919.616.4715 Party/Vendor Address: 9601 Baileywick Road City Raleigh
State: NC Zip: 27615 Department: AMS Amount: $1,400.00 Purpose: Roof repairs Budget Code(s): 61370035-
880000-30002 Vendor# 58369 (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 form and content:
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Department Director's Signature Date:y,Q„ 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:
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Office of the Risk Management Officer&OL (hnuN Date: 12/2/2016
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
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12/2/2016 Office of the Chief Financial Officer Date:
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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 Date: 12/2/2016
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloy(d c�orangecount.nic.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 5