HomeMy WebLinkAboutR 2019-020 AMS - NCSU electric motorcycle grant DocuSign Envelope ID:25158025-ADOF-4044-B3BF-3AB3BFDF53FD
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: NC State University — Sponsored Programs Party/Vendor Contact Person: Anne Leskv
Contact Phone: 919-515-2444;anne leskykncsu.edu Party/Vendor Address:2701 Sullivan Drive,Admin. Services
III Bldg., Suite 240, Campus Box 7514 (Send invoices to: Heather Brutz, NC State University, NC Clean Energy
Technology Center, Campus Box 7409, Raleigh, NC 27695) City Raleigh State: NC Zip: 27695 Department:
Asset Management Services Amount: Grant Reimbursement to County - $12,668 Purpose: Offset purchase price
for electric motorcycle. Budget Code(s): 10710030-802000 Vendor# 1787 (N/A if new vendor) Vendor is a
BOCC consultant? Yes ❑No® Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective
Date November 1,2018 Approved by Board Yes®No❑ Agenda Date:November 13,2018
This agreement is approved as to technical form and content and I as Department Director affirmatively state work
on this project has not been initiated prior to execution of the agreement:
DocuSigned by:
Department Director's Signature �� Off),40L Date: 1/11/2019
Agreements for emergency services o, ,.,Fall 3ai�11vt auvj,a:t to the above affirmation. If services related to this
agreement have already begun or been completed please briefly describe the nature of the emergency condition that
was addressed:
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:
DocuSigned
_by:
'�t
Office of the Risk Management Officer aUS66 �,bvwc,li6 Date: 1/14/2019
7FDCF91769004M-
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act:
Docusigned by:
Office of the Chief Financial Officer 4 � Date: 1/14/2019
704E51S1Ar-C1400-
Le2al Services
This agreement is approved as to legal form and sufficiency:
DocuSigned by:
Office of the County Attorney CEAAM3aED8A905__
6� K6�tv15 Date: 1/15/2019
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:
Revised 12/18