HomeMy WebLinkAboutR 2019-120 AMS - Warren Hay historic courthouse DocuSign Envelope ID: D87E10A1-498E-47C9-9A5C-831DF80D8FF1
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Warren-Hay Party/Vendor Contact Person: Ron LaPann Contact Phone: 919-732-4362
Party/Vendor Address: PO Box 818 City Hillsborough State: NC Zip: 27278 Department: AMS Amount: $1784.00
Purpose: Historic Courthouse Emergency Compressor replacement Budget Code(s): 10240320-570000 Vendor #
25352 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑
Renewal❑ Amendment ❑ Effective Date 2/22/2019 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:
UocuSigned by:
Department Director's Signature Off),40n. Date: 2/23/2019
21EF373AC0454EF..
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 ins Qocusigned by: cations,and requirements:
17FDCF0176800408
usa. cbW�.t,{�6 2/25/2019
Office of the Risk Management Officer . Date:
Financial Services
This instrument has been pre-audited in the man oocusigned by: Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer Date: 2/25/2019
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Legal Services
This agreement is approved as to legal form and siD6� K6�UocuSigned by:
Office of the County Attorney Date:2/25/2019
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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