HomeMy WebLinkAboutR 2019-284 Solid Waste - The Water Specialist landfill well repair DocuSign Envelope ID:855BE64D-4337-4C8B-912D-A231DD8ADD04
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: The Water Specialist Party/Vendor Contact Person: Contact Phone: (919) 732-1578
Party/Vendor Address: 608 Cornerstone Ct, City Hillsborough State: NC Zip: 27278 Department: Solid Waste
Amount: 4,820.00 Purpose: Well Repair Budget Code(s): Vendor#N/A (N/A if new vendor) Vendor is a
BOCC consultant? Yes ❑No® Contract Type: (Check one)New ® Renewal ❑ Amendment ® Effective Date
May 20,2019 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:
UocuSignedby.
Department Director's Signature2o .88EBU843690496
OU� AWa*5 Date:5/16/2019
Agreements for emergency services . ✓ 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:
QocuSigned by:
L,vVln
Office of the Risk Management Officer QUSA &6 Date: 5/16/2019
7FDCF9176800498.
Financial Services
This instrument has been pre-audited in the manner reauired by the Local Government Budget and Fiscal Control Act:
DocuSigned by:
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Office of the Chief Financial Officer A Date:5/20/2019
704E51S1ACC1409.
Legal Services
This agreement is approved as to legal fn—and c„ffiic;Pnow
Oocu,5igned by:
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Office of the County Attorney Date: 5/21/2019
079A4D525COF4FB.
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