HomeMy WebLinkAboutR 2019-609 Emergency Svc - Damascus Fire Dept. amendment DocuSign Envelope ID: E30BEDC7-948D-435B-A81 E-A5290EB885F3
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: City
State: Zip: Department: Amount: Purpose: Budget Code(s): Vendor #
(N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one)New ❑ Renewal
❑ Amendment ❑ Effective Date Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to technic-' „+
f pacu5igned by: - -nd I as Department Director affirmatively state work on this
project has not been initiated prior to exec CV56,55BC891A64473
{k4yffy u.
8/22/2019
Department Director's Signature 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 insurance standards, specifications,and requirements:
Office of the Risk Management Officer Date:
Fi,.,,. 1
— DocuSigned by:
This instrument has been pre-audited in the manner req " invent Budget and Fiscal Control Act:
7NE5181ACC1409. 8/22/2019
Office of the Chief Financial Officer Date:
Legal Services
OocuSigned by,
This agreement is approved as to legal form and sufficiency: � }�
4035 C B8304CA4A9 8/22/2019
Office of the County Attorney 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 6/19