HomeMy WebLinkAboutR 2017-023-E AMS - Tibbens Construction for repairs at Whitted DocuSign Envelope ID:AEDACO6E-B48B-4372-B300-7AA8EBBFCA08
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: 1700.00 Purpose: Floor Protection, Temp Carpet,Reconf. Desk, display cases
Budget Code(s): 61370035-892000-30012 Vendor# 63556 (N/A if new vendor) Vendor is a BOCC consultant?
Yes ❑ No Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 1/16/17 ,Ds
Approved by Board Yes❑No Agenda Date:
This agreement is approved as to technical form and content:
D Sg tlby.
Department Director's Signature l 2417-1"-"P"— Date: 1/18/2017
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:
r—DOCUSignetl by:
Office of the Risk Management Officer a(sa�°wu}Io Date: 1/19/2017
/1 DUFY„ebouaeb_
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act:
r—DOCUSignetl by.
Office of the Chief Financial Officer ' Date: 1/19/2017
Legal Services
This agreement is approved as to legal form and sufficiency:
�—DOOsigetl by:
col , rol,crts 1/20/2017
Office of the County Attorney D xDa Date:
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecountync.gov
The following signature block is for hard copies only and is not required for Docusign contracts:
Revised 6/16 6
DocuSign Envelope ID:AEDAC06E-B48B-4372-B300-7AA8EBBFCA08
Office of the Clerk to the Board Date:
Revised 6/16 7