HomeMy WebLinkAboutR 2017-052-E AMS - Statler Gilfillen Architects Construction for administrative services / structural services for Whitted DocuSign Envelope ID:66F0044C-A99A-45CE-9996-E7273F35FD53
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Statler Gilfillen Architect Party/Vendor Contact Person: Statler Gilfillen(Statler @outlook.com)
Contact Phone: 919.732.6123 Party/Vendor Address: 3302 St. Mary's Road City Hillsborough State: NC Zip: 27278
Department: AMS Amount: $690.00 Purpose: Construction administrative services / structural services for Whitted
Lobby service window installation Budget Code(s): 61370035-892000-30012 Vendor # 63294 (N/A if new vendor)
Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ® Renewal ❑ Amendment ❑
Effective Date 1/30/17 Approved by Board Yes❑No Agenda Date:
This agreement is approved as to technical form and content: �-DS
Department Director's Signature Date:
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:
Q(sasCortA{o 1/23/2017
Office of the Risk Management Office> OeY Date:
]�DG�O�]66004�8_.
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
DocuSignetl by.
1/24/2017
Office of the Chief Financial Office rEl°'N °" °" Date:
Legal Services
This agreement is approved as to legal form and sufficiency:
D sg any:
�,�oLIA, roNr,v{s 1/25/2017
Office of the County Attorneyt 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:
Office of the Clerk to the Board Date:
Revised 6/16 4