HomeMy WebLinkAboutR 2019-302 AMS - Advanced SealCoating Inc Paint Lines WCOB and Library DocuSign Envelope ID:321E16A8-FDB9-4A79-AA3C-51D3867DBOEO
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: Advanced SealCoating, Inc. Party/Vendor Contact Person: Dan Stark
(advancedsealcoatgatt.net) Contact Phone: 919.844.2257 Party/Vendor Address: 8804 Erinsbrook Drive City Raleigh
State: NC Zip: 27617 Department: AMS Amount: $650.00 Purpose: Restripe WCOB and Libarary Parking spaces
due to faded existing paint Budget Code(s): 61370035-880000-30029 Vendor#59959 (N/A if new vendor) Vendor
is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective
Date 5/27/18 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:
Q� �/anxn�
Department Director's Signature[IX Date:5/22/2019
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: No work has started.
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:
Office of the Risk Management Office Ksx bn1t f° Date: 5/23/2019
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Office "` Date:5/24/2019
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney �' ��° Date:5/28/2019
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