HomeMy WebLinkAboutR 2017-744 AMS - Statler Gilfillen Vestibule for Court House NTE855 DSF DocuSign Envelope ID:4760801F-0360-474B-BOD7-OBD376DD80EC
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Statler Gilfillen Architect, MBA Party/Vendor Contact Person: Statler Gilfillen
(statler(a,outlook.com) Contact Phone: 919.732.6123 Party/Vendor Address: 3302 St. Marys Road City Hillsborough
State:NC Zip: 27278 Department: AMS Amount: 855.00 Purpose: Design for Vestibule at Judge's chamber and Jury
Room Budget Code(s): 10240320-570001 Vendor# 63294 (N/A if new vendor) Vendor is a BOCC consultant?
Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 12/19/2016
Approved by Board Yes❑No® Agenda Date:
This agreement is approved as to technical form and content:
Wwi9lgned ly:
Department Director's Signature Date: 1/3/2017
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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 OfficeQCisa bnu.,t Date: 12/28/2016
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
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12/30/2016
Office of the Chief Financial Officer I
Date:
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Legal Services
This agreement is approved as to legal form and sufficiency:
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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 @ Dolloydgoran eg countync.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:
Revised 6/16 5