HomeMy WebLinkAboutR 2019-062 Child Support - Keenan Williams electrical DocuSign Envelope ID:CDA66E87-89C6-4C1 E-8E67-21 DAE5504845
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Keenan Williams Party/Vendor Contact Person: Keenan Williams Contact Phone: 9196140203
Party/Vendor Address: 730 EAGLE POINT City PITTSBORO State: NC Zip: 27312 Department: CSS Amount:
380.00 Purpose: Electrical Budget Code(s): 10-30-440-630000 Vendor#42313 (N/A if new vendor) Vendor is a
BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date
01/25/19 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:
DocuSigned by:
Department Director's Signature F gv"4 Date: 1/24/2019
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 softdavdiwompctoifications,and requirements:
Office of the Risk Management Officer LIUS0, C,bV1n,t,{}b cF�U�soaa�� Date: 2/7/2019
Financial Services
This instrument has been pre-audited in the manner req ' "+sflf�P cal Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer Date:2/7/2019
Legal Services
This agreement is approved as to legal form and suffici 7pocuSigned by:
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Office of the County Attorney J 3u3 Date: 2/7/2019
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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