HomeMy WebLinkAboutR 2019-493 AMS - Fess Fire Protection eye wash inspections DocuSign Envelope ID:98857803-1FA0-48E8-8197-358680FE68E2
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: FESS Fire Protection Party/Vendor Contact Person: Ryan Willoughby Contact Phone: 919-
469-8099 Party/Vendor Address: 131 International Dr City Morrisville State: NC Zip: 27560 Department: AMS
Amount: $1,452.13 Purpose: Annual Eyewash Inspections Budget Code(s): 10240320-630000 Vendor#60454 (N/A
if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ❑
Amendment ❑ Effective Date 7/16/2019 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:
DocuSigned by:
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Department Director's Signature Date: 7/17/2019
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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 of insr bocuSigned by:: _ ;ifications,and requirements:
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Office of1 the Risk Management Officer Date: 7/23/2019
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Financial Services
This instrument has been pre-audited in the manner DocuSigned by: - —ovemment Budget and Fiscal Control Act:
Office of the Chief Financial Officer 1 s�orx.w�ra. Date:7/2 3/2 019
7NE5181ACC1400. — -
Legal Services
This agreement is approved as to legal form an' oocuSigned'6y:
Office of the County Attorney �EAAM3aEMAW5-
6� K6k'6 Date: 7/2 5/2019
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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