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HomeMy WebLinkAboutR 2017-658 AMS - Triangle Landscaping fuel station poleRevised 2/17 6 ORANGE COUNTY—DEPARTMENT USE ONLY ______________________________________________________________________________ Department Party/Vendor Name: Triangle Landscaping, Inc Party/Vendor Contact Person: Brad Lewis (trianglelandscapemgmt@gmail.com) Contact Phone: 919-730-5267 Party/Vendor Address: PO Box 144 City Stem State: NC Zip: 27581 Department: AMS Amount: $1,130.00 Purpose: Install 4" steel pole for security camera at the AMS North Fuel station Budget Code(s): 61370035-880000-30001 Vendor # 62218 (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date October 30, 2017 Approved by Board Yes No Agenda Date: This agreement is approved as to technical form and content: Department Director’s Signature ________________________________________ Date: ________ Asset Management (Applicable only to construction contracts) This agreement has been reviewed and is approved as to construction services content and specifications: Office of the Asset Management Director__________________________________ 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 Donna Lloyd upon completion @ Dolloyd@orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: DocuSign Envelope ID: 1521D402-2DD6-4112-9C1D-31D6228F9535