HomeMy WebLinkAboutR 2017-600-E AMS - Riley Surveying, P.A. for survey of Major Business Forms property DocuSign Envelope ID: 106067F4-EOBA-48BA-B657-C7860C2AC89B
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Riley Surveying, P.A. Party/Vendor Contact Person: Phil Riley (philr@rileysurveyingpa.com)
Contact Phone: (919)667-0742 Party/Vendor Address: 3326 Durham Chapel Hill Blvd. Suite B-100 City Durham
State: NC Zip: 27707 Department: AMS Amount: $5,400 Purpose: Major Business Forms Property
Boundary/Physical Survey Budget Code(s): 61370035-870000-10020 ($2,700) & 61370035-870000-10051 ($2,700)
total $5,400 Vendor# 52775 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type:
(Check one) New ® Renewal ❑ Amendment ❑ Effective Date 11/6/2017 Approved by Board Yes' No
Agenda Date:
This agreement is approved as to technical form and content:
�--DOCUSigned by:
Department Director's Signature ;4# °p Date: 10/25/2017
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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 insurance standards, specifications, and requirements:
Doosgoea by:
QGsa(owu{rb 10/26/2017
Office of the Risk Management Office Date:
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
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Docsigea by:
Office of the Chief Financial OfficerE Date: 10/26/2017
Legal Services
This agreement is approved as to legal form and sufficiency:
�--DxuSignetl by:
�b�An 41°`'(6 10/27/2017
Office of the County Attorney Date:
99—FAAd°33EDAA0400...
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