HomeMy WebLinkAboutR 2019-325 Health - Bonitz Flooring Services SHSC carpet DocuSign Envelope ID: F772F57D-CDB6-49D8-AED6-68B334B4C6C6
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: Bonitz Flooring Party/Vendor Contact Person: Tiffany Brewer Contact Phone: 919-599-3811
Party/Vendor Address: 10701 World Trade Blvd. City Raleigh State: NC Zip: 27617 Department: Health Amount:
4 805.00 Purpose: Carpet new Navigator office Budget Code(s): 61370035-892000-30012 Vendor#N/A (N/A if
new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑
Amendment ❑ Effective Date 6-5-19 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:
DocuSigned by:
S�_Wo 5/31/2019
Department Director's Signature Date:
3C16F2D09E3445F.
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 sufficiency- -roocuSgned by-:- -'-ds, specifications,and requirements:
Office of the Risk Management Officer aCt$a (��6 Date: 6/10/2019
7FDCF9176800498.
Financial Services
This instrument has been pre-audited:Ir
Docusigned by: the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Office 4 � Date:6/10/2019
7NE5181 ACC 1469.
Legal Services
This agreement is approved as tc Docusigned by:
�KAZ ftayif, 6/10/2019
Office of the County Attorney Date:
079A40525C0F4FB.
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