HomeMy WebLinkAboutR 2017-358-E AMS - Tibbens Construction to remove tobacco barn on Homestead Rd. DocuSign Envelope ID:A294293E-AA23-4447-A1 F5-367E795AB3D8
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 Trl City Cedar Grove State: NC Zip:
27231 Department: AMS Amount: NTE $5000 Purpose: Remove old tobacco barn located on Homestead Road
and deliver Budget Code(s): 61370035-880000-10052 Vendor # 63556 (N/A if new vendor) Vendor is a
BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective
Date 8/8/14 Approved by Board Yes' No Agenda Date:
This agreement is approved as to technical form and content:
Department Director's Signature L',// _ '_ Date: 8/1/2017
Asset Management
(Applicable only to construction contracts)This agreement has been reviewed and is approved as to construction
services content and specifications:
o sy y:
Office of the Asset Management Director 74°'""°" Date: 8/1/2017
Risk Management
This agreement is approved for sufficiency of insurance standards, specifications,and requirements:
oos�yea ey:
Qlisa(01W-to 8/1/2017
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:
—m<s�yea ey:
8/1/2017
Office Office of the Chief Financial Officer Date:a,q
Legal Services
This agreement is approved as to legal form and sufficiency:
�—oos�yea ey:
,)o1uA,roknts 8/1/2017
Office of the County Attorney, 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 2/17 6