HomeMy WebLinkAboutR 2017-505-E AMS - Statler Gilfillen Architect for drawing of house at 1127 SR70 DocuSign Envelope ID: DE3C75A2-D215-4D84-9DF5-10E37FC04906
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: $980.00 Purpose: Drawing for house at 1127 SR70 Budget Code(s): 10240320-630000
Vendor# 63294 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one)
New ® Renewal ❑ Amendment ❑ Effective Date 8/31/17 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
-FLUnn4e°"^"'
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:
Qlisa 6ortalfo 9/5/2017
Office of the Risk Management Office „ Date:
Financial Services OS
l "i5 This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer '� Date: 9/7/2017
Arr 1494
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney )0t �0�``�s Date: 9/8/2017
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