HomeMy WebLinkAboutR 2019-187 AMS - Sasser Companies Millhouse winterization DocuSign Envelope ID:312E447C-BD95-4024-ACDC-28704AF55BBD
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: $650.00
Purpose: Millhouse House Winterization Budget Code(s): 61370035-800000-20037 Vendor # 65006 (N/A if new
vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ❑
Amendment ❑ Effective Date 3/25/2019 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:
DocuSigned by:
Department Director's Signature FMAJA, 06 MWA, Date:3/21/2019
Agreements for emergency services or repair are not su Ject 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 insura%&,*.% A'"W'dss,�,specifications,and requirements:
Office of the Risk Management Officer PUS& rbvv�.�lib Date:3/22/2019
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in them aunt Wby the Local Government Budget and Fiscal Control Act:
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Office of the Chief Financial Officer Date: 3/22/2019
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Legal Services
This agreement is approved as to legal �aaffigiency:
�b� rbbt V s 3/22/2019
Office of the County Attorney 465 Date:
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