HomeMy WebLinkAboutR 2019-035 AMS - Sidewalk Edge Grinding-Seymour and Passmore DocuSign Envelope ID: D4966361-0983-4ABD-B54D-70D58DB5C632
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Triangle Landscaping Inc. Party/Vendor Contact Person: Brad Lewis Contact Phone: 919 730-
5267 Party/Vendor Address: PO Box 144 City Stem State: NC Zip: 27581 Department: Asset Management
Amount: $1,145.00 Purpose: Grind concrete in sidewalks and patios at Passmore and Seymour Centers along raised
edges where concrete has subsided. All appropriate PPE will be used during concrete grinding. Budget Code(s):
10240320-570000 Vendor# 62218 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract
Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date January 22,2019 Approved by Board Yes
❑No® Agenda Date:
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:
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Department Director's Signature t� Date:1/22/2019
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Agreements for emergency services or repair are not subject 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:
Qtasa �vtiuffb 1/22/2019
Office of the Risk Management Officer Date:
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Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
Docu3igned W, 1/2 3/2019
Office of the Chief Financial Officer�{� Date:
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Legal Services
This agreement is approved as to legal form and sufficiency:
Docu&!gwd by:
Office of the CountyAttorney rr � 1/24/2019
y ,�bLs.1rt. Xa�k.V�'s Date:
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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:
Revised 12/18 4