HomeMy WebLinkAboutR 2019-572 Planning - Wellsmont Landscaping Lake Orange fence stump removal DocuSign Envelope ID: F52521E7-10C1-43F9-B62F-C1E599A5D572
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: Douglas P. Malinowski Party/Vendor Contact Person: Douglas P. Malinowski Contact Phone:
919-810-6282 Party/Vendor Address: 1005 Dimmocks Mills Road City Hillsborough State: NC Zip: 27278
Department: Planning Amount: $3,125.00 Purpose: FY19-20 Stu= Removal and Fence Repair at Lake Orange Dam
Budget Code(s): 10695020-720013 Vendor#64686 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑
No® Contract Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date August 23, 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:
Department Director's Signature �'�� '`�`L Date: 8/19/2019
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 insurance standards,specifications,and requirements:
Office of the Risk Management Officer etas"bnu ff0 Date: �tas�dew dte
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
8/20/2019
Office of the Chief Financial Officer Date:
Legal Services
This agreement is approved as to legal form and sufficiency:
�° 8/20/2019
Office
of the County Attorney J�"�S bri— Date:
C�eae.w�.�
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