HomeMy WebLinkAboutR 2019-124 AMS - Chapel Hill Moving ES to Churton Grove DocuSign Envelope ID:21E45AAC-B416-4F84-9134-CAOFD22739B8
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ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: Chapel Hill Moving Party/Vendor Contact Person: Ethan Smith Contact Phone: 919.929.6683
Party/Vendor Address: 7401 Rex Rd., Suite 104 City Chapel Hill State:NC Zip: 27516 Department: AMS Amount:
NTE $1530 Purpose: move from 300 W Tryon & 131 W Marg Ln to Churton Grove Budget Code(s): 61370035-
880000-10068 Vendor#65179 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No❑ Contract Type:
(Check one) New ® Renewal ❑ Amendment ❑ Effective Date 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 9� Off),40L Date: 2/26/2019
Agreements for emergency services or__r?EF373Ac❑a54EF J__t 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:
Docusigned by:
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Office of the Risk Management Officer Date:2/27/2019
7FDCF9176900498. D.S
Financial Services
This instrument has been re-audited in the ir�-----�_-oc..S,.igned...:_by:,.a,-.`' T-)cal Government Budget Bud et and Fiscal Control Act:
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Office of the Chief Financial Officer i ' a, `�' " Date: 2/28/2019
7NE5181 ACC 1400-
Legal Services
This agreement is approved as to legal fora and enffu-i,-nw-
UocuSigned by:
Office of the County Attorney �6LW Pk�lfs Date?/28/2019
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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