HomeMy WebLinkAboutR 2017-636-E DEAPR - Fire Safe Chimney Sweep to repair, renovate chimney DocuSign Envelope ID: 3038F92E-742A-4AA4-BDCE-980F4D400885
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Fire Safe Chimney Sweep Party/Vendor Contact Person: Bob Perera Contact Phone:
919.304.6111 Party/Vendor Address: 4127 Hidden View Dr City Mebane State: NC Zip: 26302 Department:
DEAPR Amount: $3,409.83 Purpose: Repair/reno chimney Budget Code(s): 61370035 880000 20039 Vendor#
64848 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No Contract Type: (Check one)New
Renewal ❑ Amendment ❑ Effective Date 11/10/2017 Approved by Board Yes❑Non Agenda Date:_
This agreement is approved as to technical form and content:
DocuSigned by:
Department Director's Signature Sf A,IAtt Date: 11/16/2017
611CFA1D507A495...
Asset Management
(Applicable only to construction contracts)This agreement has been reviewed and is approved as to construction
services content and specifications:
DocuSigned by:
Office of the Asset Management Director ?o+wpoon Date:
11/21/2017
9E880A46CF64498...
Risk Management
This agreement is approved for sufficiency of insurance standards,specifications,and requirements:
DocuSigned by:
Office of the Risk Management Officer rLtSa, Cbrin'ft Date: 11/22/2017
7FDCF9176800498...
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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 11/22/2017
C7? Date:
7D4E5181ACC1409_ i.
Legal Services
This agreement is approved as to legal form and sufficiency:
DocuSigned by:
Office of the County Attorney 1O(UA. bt tY S Date: 11/22/2017
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 10/17 6
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