HomeMy WebLinkAboutR 2016-702-E AMS - Tibbens Construction to repair Dickson House front porch DocuSign Envelope ID:82EB9B39-9D7D-41C3-B72D-42EA9D2C18CD
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Tibbens Contruction 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: 1325.00 Purpose: Repair Dickson House front porch steps 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 12/19/16 Approved by Board Yes❑
No® Agenda Date:
This agreement is approved as to technical forth and content:
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Department Director's Signature Date: 12/13/2016
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:
oo..s�g.ea ey:
QUSO,(,awu 6 12/14/2016
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:
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Office of the Chief Financial Officer�!d? Date: 12/14/2016
Legal Services
This agreement is approved as to legal forth and sufficiency:
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Office of the County Attorney �6 " r6 S Date: 12/15/2016
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Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloy(d c�orangecount.plc.gov
The following signature block is for hard copies only and is not required for Docusign contracts:
Revised 6/16 6