HomeMy WebLinkAboutR 2016-734 AMS - Scott Haigler Electric DSS building DocuSign Envelope ID: D78897AD-7725-4356-86DA-680ODBOE8CC8
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
PartylVendor Name: Scott Haigler Electric Party/Vendor Contact Person: Scott Haiglcr Contact Phone: 919-479-
9550 PartyNendor Address: 6616 Blalock Rd City Bahama State: NC Zip: 27503 Department: AMS Amount:
$5,000.00 Purpose: DSS Electrical Estimate Budget Code(s): 10400130-803000 Vendor # 62639 (hl`/A if new
vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ❑
Amendment ❑ Effective Date 5/25116 Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to technic Docusigned by:
I fao at.
Department Director's Signature Date: 6/2/2016
9E88CA40CF64498... -
Information Technologies
(applicable only to hardware/softivare purchases or related services)This agreement has been reviewed and is
approved as to inforrriation technology content and specifications:
Office of the Chief Information Officer Date:
Risk Management
This agreement is approved for sufficiency of ine,trnnrr+.Onndards,specifications,and requirements:
QocuSigned_by:.
Office of the Risk Management Officer QUS& (h 6 Date: 6/3/2016
7MCF917E800498...
Financial Services
This instrument has been pre-audited in ' oocusigned by: ie Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer 41.41/. Date: 6/6/2016
704E5181ACC1409...
Ley al Services
This agreement is approved as to'°��' `-m °--'---'-ienc :
g l}ll Uocusigned by: y
�I� LW Office of the County Attorney 8 � Date:6/8/2016
EAAM3aEMAW5 i
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion a Dollo d gran ecoun c. ov
I
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 1/16 5