HomeMy WebLinkAboutR 2019-173 Planning - Moffat Pipe change order #8 1
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ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name : Moffat Pipe Inc . Party/Vendor Contact Person : Jesse DuClau Contact Phone : 919 -235 - 5149
Party/Venylor Address : 4901 Unicorn Dr. City Wake Forest State $ NC Zip : 27587 Department : Planning &
IInn sections Amount : $ 0 . 00 Purpose : Change Order # 8 Budget Code ( s) : 61370035 - 88000040054 Vendor #
1801656 (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 a ement :
Department Director ' s Sign Date :
Agreements for emergency s vices or r air are not ' ject to the above affirmation . If serv ' es relat d 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 :
Office of the Risk Management Officer �- - � ` _ Date . z
Financial Services
This instrument has been pre - audited in the in er re it d by the Local Government Budget and Fiscal Control
Act :
Office of the Chief Financial Officer Date : 31a5lly
Legal Services
This agreement is approved as to legal form and sufficiency :
Office of the County Attorney Date :
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 l � <�
Date :
Revised 12/ 18