HomeMy WebLinkAboutR 2018-001 AMS - Penta Engineering GroupDocuSign Envelope ID: FC33DOBE- 4D4D- 45AF- 857C- 2498EBC91861
ORANGE COUNTY - DEPARTMENT USE ONLY
Department
Party/Vendor Name: Penta Engineering Group, Inc Party/Vendor Contact Person: Dan Blair
(dblairna,pentaeng com) Contact Phone: 919 - 455 -0212 Party/Vendor Address: 4000 Miller Court West City
Norcross State: GA Zip: 30071 Department: AMS Amount: $4,140.00 Purpose: Asbestos Sampling at Whitted
A &B Roof Parapet Walls, Asbestos Sampling at Passmore Center Entrance for Expansion, Air Quality Testing at
208 South Cameron Street Board of Elections Budget Code(s): (Government Services Annex) 61370035-880000 -
10008 $1,950.00, (Whiffed Bldg A &B Parapet Walls Asbestos Sampling) 61370035- 882000 -30002 $940.00.
Passmore Center Renovation Asbestos Sampling) 61370035- 880000 -10023 $1,250.00 Vendor # 61470 (N /A if
new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑
Amendment ❑ Effective Date 12/29/2017 Approved by Board Yes❑ No® Agenda Date:
This agreement is approved as to technical form and content:
D_ Signed by:
Department Director's Signature[ Date 12/27/2017
9EgggA45CF69M198...
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
Risk Management
Date:
This agreement is approved for sufficiency of insurance standards, specifications, and requirements:
D sg aby:
Office of the Risk Management Office QGsa (Avuu ffe Date: 12 /28/2017
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Financial Services
E Plg This instrument has been pre- audited in the manner required by the Local Government Budget and Fiscal Control
Act:
r0 S'g ea by:
Office of the Chief Financial Officer I A-411 " Date: 1/2/2018
Legal Services
This agreement is approved as to legal form and sufficiency:
0—Sig a by:
Office of the County Attorney 4e� Date: 1/2/2018
EAA3D33EDBA868g_.
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd(koran-et� countync.gov
The following signature block is for hard copies only and is not required for Docusign contracts:
Revised 10/17
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