HomeMy WebLinkAboutR 2019-241 DEAPR - Riley Surveying Twin Creeks DocuSign Envelope ID: F8057E6E-3837-4DFE-AEF9-BD8F83298798
ORANGE COUNTY—DEPARTMENT USE ONLY
PartyNendor Name: Riley Surveying P.A. Party/Vendor Contact Person: Jose Torres Contact Phone: 919-667-0742
Party/Vendor Address: 3326 Durham Chapel Hill Blvd Suite B-100 City Durham State:NC Zip: 27707 Department:
DEAPR Amount: $3,500 Purpose: Togo Survey work Budget Code(s): 61370035 860000 20003 Vendor# 52775
(N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New ® Renewal
❑ Amendment ❑ Effective Date 4/12/19 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:
DocuSigned by:
Department Director's Signatu rum' Date: 4/15/2019
Agreements for emergency servicf a w,5 I;a;.°�'V:;,,,object 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 Technoloizies
(Applicable only to hardwarelsofhvare 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: i�tt
Office of the Risk Management Office && c bvw lib Date:4/17/2019
7FDCF9176900498. DS
Financial ServicesIr
F
This instrument has been pre-audited *pocu5igned dy"�"''"�'`'y the Local Government Budget and Fiscal Control Act:
4/18/2019
Office of the Chief Financial Office '� UaEc:
7D4E51S1ACC1409.
Legal Services
This agreement is approved as—'iiocusifined --1"'•fficiency:
Office of the County Attorne �66A, K6ku'6 Date: 4/22/2019
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