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HomeMy WebLinkAboutR 2019-391 AMS - Siemens Cedar grove Panel (2) DocuSign Envelope ID: DAFC7BC0-27FF-4433-AC79-DA33894C5C89 GRANGE COUNTY---DEPARTMENT USE ONLY Party/Vendor Name: Siemens Indus" Inc Party/Vendor Contact Person: _ Contact Phone: 336-574-3060 Party/Vendor Address: 215 Southport Dr Suite_900 City Morrisville State: NC lip: 27560 Department: AMS Amount:$912.68.00 Purpose:Cedar Grove Panel Repair Budget Code(s): 10240320-570000 Vendor#53325 (N/A if new vendor) Vendor is a BOCC consultant? Yes [] No❑ Contract Type: (Check one)New ❑ Renewal ❑ Amendment ❑ Effective Date 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 initiated prior to execution of the agreement: UocuSigned by: �W' Pbl't+►1GUA' 6/28/2019 Deparimeni Director's Signature 21 EF373Aco454EF-- Date' 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 I (Applicable onbl to hardwarelsof}care purchases or related services)This agreement has been reviewed and is I; approved as to information technology content and specifications: Office of the Chief Information Officer Date: Risk Management This agreement is approved for sufficiency of insure-----D-o'c-u--A USA �11- : " Sig c6nu �b-- -- ications,and requirements: a Office of1 the Risk Management Officer USA 6/28/2019 7F©CF917E800498- Financial Services This instrument has been pre-audited in the 6/29/2019 Date:ma DocuSigned dy: al Government Budget and Fiscal Control Act: Office of the Chief Financial Officer' _ --- 704E51S1ACC1409- Legal Services This agreement is approved as to legal form 'oocusigned by: � Office of the County Attorney b� Pk�f5 __Date: 7/1/2019 El+A3033EO8A8435.. Clerk to the Board Received for record retention: All Docusign contracts must be copied to Sherri Ingersoll upon completion: singerso[l@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 12/19 4