HomeMy WebLinkAboutR 2018-161 AMS - Excellance Remounting ContractORANGE COUNTY—DEPARTMENT USE ONLY
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Department
Party/Vendor Name: Excellance, Inc.Party/Vendor Contact Person: Lisa BarfieldContact Phone: (256) 772-9321
Party/Vendor Address: 453 Lanier RdCity MadisonState: ALZip: 35758Department: Emergency Services
Amount: $117,374.75Purpose: Ambulanc Remount #899Budget Code(s): 72757530 –802000 Vendor # 59564
(N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New
Renewal Amendment Effective Date Approved by Board Yes No Agenda Date: CIP
Budget FY18
This agreement is approved as to technical form and content:
Department Director’s Signature ________________________________________ Date: ________
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:
Office of the Risk Management Officer___________________________________ Date: _________
Financial Services
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: _________
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney __________________________________________Date: ________
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Sherri Ingersollupon completion @ Singersoll@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:_________
DocuSign Envelope ID: D329DEE1-1083-4935-A32C-FC00DAA234AC