HomeMy WebLinkAboutR 2019-292 DEAPR - Axiom Environmental Blackwood Farm Park DocuSign Envelope ID: EFA046A9-1DCB-4ED7-98BA-B96A823B3D45
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Axiom Environmental, Inc. Party/Vendor Contact Person: Alexander Smith; Contact Phone:
919-270-9306 Party/Vendor Address: 218 Snow Ave. City Raleigh State: NC Zip: 27603 Department: DEAPR
Amount: 2,292.00 Purpose:Environmental Work Budget Code(s): 61370035 880000 20037 Vendor#65665 (N/A if
new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑
Amendment ❑ Effective Date 5/22/2019 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:
DocuSignedd by:
Department Director's Signatu e 10 �fay�.ctl, Date:5/21/2019
Agreements for emergency service VL$ft1QW64hbt 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 sufficiency of insurance standards, specifications,and requirements:
FDocuSigned by:
rausa,Office of the Risk Management Offic 6606 Date: 5/22/2019 Ds
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in t1le Nann�e�r required by the Local Government Budget and Fiscal Control Act:
ocu Igoe y:
Office of the Chief Financial Offic (�" 0.&1. Date:5/22/2019
7D4E5181ACC1409...
Legal Services
This agreement is approved as to le lufso9md%Vd sufficiency:
^�� ��� 5/23/2019
Office of the County Attorney J Date:
EAA3D33ED8A8465...
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