HomeMy WebLinkAboutR 2018-673 Planning - Douglas P. Malinowski Efland Sewer Easement clearingRevised 10/17 (Mgr apprv 5k 6/18)4
ORANGE COUNTY—DEPARTMENT USE ONLY
______________________________________________________________________________
Department
Party/Vendor Name: Douglas P. MalinowskiParty/Vendor Contact Person: Douglas P. MalinowskiContact Phone:
919-810-6282Party/Vendor Address: 1005 Dimmocks Mill RoadCity HillsboroughState: NCZip: 27278
Department: PlanningAmount: $3,300.00Purpose: Efland Sewer - Easement Clearing (Fall 2018)Budget Code(s):
51360120-571000Vendor # 64686(N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract
Type: (Check one) New Renewal Amendment Effective Date October 05, 2018Approved by Board Yes
No Agenda Date: N/A
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 Ingersoll upon 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: 0367C8AB-A6A6-4692-81B5-A3CECE426B4E