HomeMy WebLinkAboutR 2019-074 AMS - Penta Engineering Asbestos Testing 510 Meadowlands DocuSign Envelope ID:927B36D7-1719-466F-9E34-D267CB3B1E3F
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Penta Engineering Group, Inc Party/Vendor Contact Person: Dan D. Blair, Jr, PE
(dblair(d)pentaeng com) Contact Phone: 919.455.0212 Party/Vendor Address: 4000 Miller Court West City a�
Norcross State: GA Zip: 30071 Department: AMS Amount: $3,200.00 Purpose: Asbestos Testing for 510
Meadowlands Drive Budget Code(s): 61370035 870000 10068 Vendor#61470 (N/A if new vendor) Vendor is
a BOCC consultant? Yes ❑No® Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective
Date 2/5/19 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:
Docusignea cy:
Department Director's Signature["^ '�S Date: z/11/zo19
Sg55BCgg1Ag44]3..
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: N/A
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:
D sg acy:
Office of the Risk Management Office a'sa 6....: o Date:2/11/2019
7FISL`F§T
Financial Services
LDS This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
PF Act:
DocuSig—by:
Office of the Chief Financial Officer[ Date:2/12/2019
Legal Services
This agreement is approved as to legal form and sufficiency:
D Mgn.d by:
Office of the County Attorne �0�""�a�wfi Date:2/12/2019
�E 3D3 E gA84 5..
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
9