HomeMy WebLinkAboutR 2017-469-E AMS - Riley Survey, P.A. for FEMA Elevation Certificate to move HVAC and electrical equipment at BOE DocuSign Envelope ID:2D2FC031-D998-499D-8152-4D0C1 B8B6D3D
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Riley Surveying, P.A. Party/Vendor Contact Person: Phillip W. Riley
(Philr@rileysurveyingpa.com) Contact Phone: 919.667-0742 Party/Vendor Address: 3326 Durham Chapel Hill Blvd
Ste.B-100 City Durham State:NC Zip: 27707 Department: AMS Amount: $1,200.00 Purpose: Board of Elections-
provide field measures and computations for the FEMA certification to obtain flood plain information for moving the
HVAC and Electrical Equipment above flood plain. Budget Code(s): 61370035-880000-10008 Vendor# 52775 (N/A
if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one)New ® Renewal ❑
Amendment ❑ Effective Date 9/12/17 Approved by Board Yes No Agenda Date:
This agreement is approved as to technical form and content:
Department Director's Signature � w Date: 8/31/2017
P F449A
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:
( ousignetl by
Office of the Risk Management Office T a('6 vtiuff6 Date:8/31/2017
Financial Services
o; This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
l Office of the Chief Financial Office el" 'A 4°°" ' Date: 9/1/2017
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Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney 9o " b s Date: 9/1/2017
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Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd @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