HomeMy WebLinkAboutR 2019-268 DEAPR - Summey Portable Restrooms DocuSign Envelope ID:2049FC36-OD70-41CA-B8EA-9117OB9D8CEF
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Summey Portable Restrooms Party/Vendor Contact Person: Christy Freeman Contact Phone:
336-417-1816 Party/Vendor Address: 2805 Miller Road City Hillsborough State: NC Zip: 27278 Department:
DEAPR Amount: $1,575 Purpose: Waste Disposal of Restroom Trailer Budget Code(s): 630000 Vendor # 62844
(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:
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Department Director's Signature Date:4/30/2019
871CFA1D507A495..
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 sufficient DocuSigppned by: rds, specifications,and requirements:
aUsa LQ 6 5/7/2019
Office of the Risk Management Office 7FDCF9176800498. Date:
Financial Services
This instrument has been pre-audited it17D4E,l,lA,,l,,,
DocuSigned by: the Local Government Budget and Fiscal Control Act:
4 � 5/8/2019
Office of the Chief Financial Officer . Date:
Legal Services
This agreement is approved as t af�, �a�w�s / /
DocuSigned by: iciency:
Office of the County Attorney Date: 5 8 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
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