HomeMy WebLinkAboutR 2019-481 AMS - Summey Portable Restrooms contract extension DocuSign Envelope ID:76865915-80B4-4DED-A27B-62FD8E3D323A
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: Summey Portable Restrooms Party/Vendor Contact Person: Harold Summey Contact Phone: 919.259.62
Address: 2805 Miller Rd City Hillsborough State: NC Zip: 27278 Department: AMS Amount: Increase Original PO 19018'
$4,500.00. This is an increase of$2,700.00 Purpose: Emergency Services Trailer monthly restroom tank rental and pumping services
61370035-880000-10068 Vendor#62844 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Cl
Renewal® Amendment ❑ Effective Date 7/29/2019 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
prior to execution of the agreement:
Q�P/anx� 7/15/2019
Department Director's Signature[IX _pF Date:
Agreements for emergency services or repair are not subject to the above affirmation. If services related to this agreement have alread:
completed please briefly describe the nature of the emergency condition that was addressed: N/A-Services under existing contract ex
2019.
Risk Management
This agreement is approved for sufficiency of insurance standards, specifications,and requirements:
Office of the Risk Management Office l s" bn1t f° Date: 7/16/2019
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
PL
Office of the Chief Financial Office "` Date: 7/18/2019
Legal Services
This agreement is approved as to legal form and sufficiency:
Y b 7/22/2019
Office of the County Attorney[—n R 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 Date:
Revised 12/18