HomeMy WebLinkAboutR 2019-390 AMS - Siemens Cedar Grove Panel (1) DocuSign Envelope ID:8B33E7F9-56F2-4F51-A7E8-3B3F4ADFDA6D
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor- Name: Siemens Industry Inc Party/Vendor Contact Person: — Contact Phone: 336-574-3060
Party/Vendor Address: 215 Southport Dr Suite 900 City Morrisville State: NC Zip: 27560 Department: AMS
Amount: $798.80 purpose: Cedar Grove Panel Repair- Budget Code(s): 10240320-570000 Vendor 4 53325 (N/A if
new vendor-) Vendor is a BOCC consultant? Yes ❑ No[] Contract Type: (Check one) New ❑ Renewal ❑
Amendment ❑ Effective Dale 06/14/2019 Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to technical form and content and I as Department Director affirmatively state work on
this project has not been initialed prior to execution of the agreement:
DocuSigned by:
'I6 6/28/2019
Department Director's Signature Date:
21EF373ACD454EF..
Agreements for emergency services or repair are not subject to the above affirmation. If services related to this
agreement have already begun or been completed please briefly describe the nature of the emergency condition that was
addressed: Fire system in trouble status causing alarm to activate and sound hourly.
Information Technologies
(,4pplicable onl),to harrhvarelsoftware purchases or related services}This agreement has been reviewed and is
approved as to information technology content and specifications:
Office of the Chief Information Officer Date:
Risk Mann ement
This agreement is approved for sufficiency of insurn --l—Ac --ifications,and requirements:
WcuSigneed_by:
Office of the Risk Management Officer 1U$A, r"_ W 6 Date:6/28/2019
7FDCF917e800498.
Financial Services
This instrument has been pre-audited in the ma Docusigned by: d Government Budget and Fiscal Control Act:
Office of the Chief)Financial Officer � Date:6/29/2019
7D4E5181Ar-C1400.
Legal Services
This agreement is approved as to legal forth and su-J bocusigned by:
Office of the County Attorney �b Date:7j1/2019
EAA3D33EDSAW5..
Cleric to the Board
Received for record retention:
All Docusign contracts must be copied to Sherri Ingersoll upon completion: singei,soll@orangecountync.gov
The following signature block is for hard copies only and is not requh-ed for Docusign contracts:
Office of the Cleric to the Board Date;
Revised 12/18 4