HomeMy WebLinkAboutR 2019-112 AMS - Sasser Companies Churton Grove door DocuSign Envelope ID:346FBD68-AA75-4ED4-92B4-DAEBBF5D627F
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Sasser Companies Party/Vendor Contact Person: Kevin Sasser Contact Phone: 336-449-1144
Party/Vendor Address: PO Box 10 City Whitsett State: NC Zip: 27377 Department: AMS Amount: 1577 Purpose:
Churton Grove Door Budget Code(s): 61370035-880000-10068 Vendor#65006 (N/A if new vendor) Vendor is a
BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date
02/22/19 Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to technical form and content and I as Department Director affirma os ite work on
this project has not been initiated prior to execution of the agreement: L�1_1
DocuSigned by:
Department Director's Signature 'Lila, pbV� Date?/20/2019
Agreements for emergency services or re 21 EF373ACD454EF-- 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:
2019
Office of the Risk Management Officer 2/2DS —
g ��Sa �,bVln.f,{�6 Date:_
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7FDC F9176800498-
Financial Services
This instrument has been pre-audited in th- DocuSigned by: "—`-Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer 01.44� Date: 2/22/2019
7D4E5981ACC1409-
Legal Services
This agreement is approved as to legal form nrid cnffit-ienov
DocuSigned by:
2/22/2019
Office of the County Attorney �6� K6 Y S Date:
EAA3D33ED8AW5--
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