HomeMy WebLinkAboutR 2017-038-E DEAPR - Fearnbach History Services, Inc. for National Register Nomination for the Historic Efland Home Property DocuSign Envelope ID: D06E82C3-FAA9-41 B3-B3B8-714BEBE7E61E
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Fearnbach History Services, Inc. Party/Vendor Contact Person: Heather Fearnbach, President
Contact Phone: (336) 765-2661 Party/Vendor Address: 3334 Nottingham Road City Winston-Salem State: NC Zip:
27104 Depaitnient:DEAPR Amount: $5,500.00 Purpose:National Register Nomination for the Historic Efland Home
Property Budget Code(s): 61370035 850000 20011 Vendor # 64264 (N/A if new vendor) Vendor is a BOCC
consultant? Yes❑No Contract Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date Jan 18,
2017 Approved by Board Yes❑No® Agenda Date:
This agreement is approved as to technical form and content:
DocuSigned by:
Department Director's Signature PAAt, Date: 1/20/2017
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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:
DocuSigned by: �.�.
Office of the Risk Management Officer 1tLt o, (,ov'tnd,{fb Date:1/24/2017
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Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
DocuSigned by: =-
Office of the Chief Financial Officer Date: 1/24/2017
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Legal Services
This agreement is approved as to legal form and sufficiency:
DocuSigned by:
Office of the County Attorney !jbLt , Vbtit,V+s Date: 1/24/2017
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Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd(a/orangecountync.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