HomeMy WebLinkAboutR 2019-514 AMS - G2 Design PA stormwater inspections DocuSign Envelope ID:8684E56C-OA47-4C41-A3F9-AE9C772AAF71
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: G2 Designs P.A Party/Vendor Contact Person: Tim Grady Contact Phone: 919-321-0638
Party/Vendor Address: P.O Box 297 City Apex State:NC Zip: 27502 Department:AMS Amount: $950.00 Purpose:
Seymour Annual Storm Water Control Inspections Budget Code(s): 10240320-630000 Vendor# 64902 (N/A if new
vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ❑
Amendment ❑ Effective Date 07/01/2019 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 dy-
�W P6V*aan. 7/29/2019
Department Director's Signature 21 EF373ACD454EF.. 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:
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 insura Docusigned by: icatlons,and requirements:
17FDCF0176900498
usa. LQVIn 6 7/30/2019
Office of the Risk Management Officer . Date:
Financial Services
This instrument has been pre-audited in the man Docusigned'by: - Government Budget and Fiscal Control Act:
s/JmrxR . 7/30/2019
Office of the Chief Financial Officer Datc:
7D4E51S1ACC1409. -
Legal Services
This agreement is approved as to legal form ai [ DocuS.igned by:
Office of the County Attorney � Date: 7/30/2019
EAA3D33EDSAM65..
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