HomeMy WebLinkAboutR 2019-267 AMS - Riley Surveying Battle roof DocuSign Envelope ID:8CFODBE7-8B79-49E2-92BC-06D4EO10765E
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ORANGE COUNTY—DEPARTMENT USE ONLY Qi
Party/Vendor Name: Riley Surveying P.A. Party/Vendor Contact Person: Phil Riley Contact Phone: 919-667-0742
Party/Vendor Address: 3326 Durham Chapel Hill Blvd, Ste B-100 City Durham State: NC Zip: 27707 Department:
AMS Amount: $1170 Purpose: Battle Court Roof Budget Code(s): 61370035-882000-30002 Vendor# 52775 (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:
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Department Director's Signature �W PbV*aaA. Date: 5/7/2019
Agreements for emergency services or rep, 21EFMACD454EF.. he 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: This work was approved by the former Asset Management Services Director,and funding advice was
finalized 03/20/19 by new director for CIP.
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:.
Office of the Risk Management Officer 9Usa ('6 6 Date: 5/7/2019
7FOCF9176800498. DS
Financial Services Ir
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This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
DocuSigned by:
Office of the Chief Financial Officer � '� '� Date: 5/8/2019
7NE5181 ACC 1400-
Legal Services
This agreement is approved as to legal forr- ^—Uoeusigned by,
Office of the County Attorney �6LW Pkk�s Date: 5/8/2019
EAA3MaEMA905..
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