HomeMy WebLinkAboutR 2017-474-E DEAPR - N.W. Poole Well & Pump Co. to repair irrigation system DocuSign Envelope ID: 3DA3CD72-390C-4765-969A-9FC5040C04E7
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: N.W. Poole Well & Pump Co. Party/Vendor Contact Person: Iris Letchworth Contact Phone:
(919) 266-9223 Party/Vendor Address: P.O. Box 1958 City Wendell State: NC Zip: 27591 Department: DEAPR
Amount: $2,300.00 Purpose: Repair Irrigation System Budget Code(s): 61370035 880000 20039 Vendor # 60487
(N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one)New ® Renewal
❑ Amendment ❑ Effective Date September 1,2017 Approved by Board Yes❑No Agenda Date:
This agreement is approved as to technical form and content:
DocuSigned by:
Department Director's Signature NW. St tlA. 1t Date:
611CFA1 D507A495...
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:
6V1At 0
Office of the Risk Management Officer
Qtistk. (, Date:
7FDCF9176800498...
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 (714, +� �, 67? Date:
7D4E5181ACC1409_.
Legal Services
This agreement is approved as to legal form and sufficiency:
DocuSigned by:
Office of the County Attorney l°elit 1tS Date:
EAA3D33ED8A8465...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloydAorangecountync.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