HomeMy WebLinkAboutR 2019-541 AMS - Brown Bros. Whitted sewer repair DocuSign Envelope ID: FDEAE919-EFF3-415A-AOE5-783A71BAE682
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: Brown Brothers Plumbing & Heating, Co Inc Party/Vendor Contact Person: Jeff Addison
Contact Phone: 919-220-2554 Party/Vendor Address: 2820 N Roxboro Rd City Durham State: NC Zip: 27704
Department: AMS Amount: $1200.00 Purpose: Whitted Sewer Line Cleaning Budget Code(s): 10240320-570000
Vendor# 35730 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one)
New❑ Renewal ❑ Amendment ❑ Effective Date 8/2/2019 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-
��' 06V*0' 8/2/2019
Department Director's Signature 21EFMAGD454EF_. 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 insr-----Docusignea ay- ----ifications,and requirements:
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Office of the Risk Management Officer USA, �,bb Datc:8/6/2019
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Financial Services
This instrument has been pre-audited in the manner n Docusigned by: - emment Budget and Fiscal Control Act:
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Office of the Chief Financial Officer Date:8/6/2019
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Legal Services
This agreement is approved as to legal form an DoeuSigned by:
I
66A, K6�C '6 8/7/2019
Office of the County Attorney EAA3D33ED8AW5.. 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 4