HomeMy WebLinkAboutR 2017-407-E AMS - Tile Restoration Inc. for restrooms, kitchen, housekeeping closet at 129 E. King St. DocuSign Envelope ID: FCA0E1BB-47B7-480B-A920-86DA50EE65BC
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Tile Restoration Inc Party/Vendor Contact Person: Brad Albritton Contact Phone: 252-916-2045
Party/Vendor Address: 119 East Main Street City Hookerton State: NC Zip: 28538 Department: AMS Amount:
$2,480.88 (less $255.88 deposit already paid) Purpose: Restrooms, Kitchen & Housekeeping Closet Tile & grout
surface at 129 E King St Budget Code(s): 10240520-630000 Vendor # 61702 (N/A if new vendor) Vendor is a
BOCC consultant? Yes ❑ No❑ Contract Type: (Check one)New® Renewal El Amendment El Effective Date
09/01/2017 Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to technical form ar{ts,g Agy:
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Department Director's Signature Pell Date: 8/25/2017
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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 insura� s,larA Ards, specifications,and requirements:
((USA COVI/ut t 8/25/2017
Office of the Risk Management Officer Date:
7FDCF9176800498...
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Financial Services r DS
This instrument has been pre-audited in the ma wcwittirrixbby the Local Government Budget and Fiscal Control Act:
6/4 8/25/2017
Office of the Chief Financial Officer Date:
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Legal Services
This agreement is approved as to legal form and suf qig. yd:by:
jaLtA, lebltxfs 8/25/2017
Office of the County Attorney Date:
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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 2/17 5