HomeMy WebLinkAboutR 2019-625 AMS - Fire Brand Cedar Grove fire door inspection DocuSign Envelope ID:C244DA8B-F5FA-452D-96CC-93C13A7F4498
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: Firebrand Pro Party/Vendor Contact Person: Mark Mitchell Contact Phone: 336-516-0908
Party/Vendor Address: 3349 Winston Drive City Burlington State: NC Zip: 27215 Department: AMS Amount:
550.00 Purpose: Cedar Grove Fire Door Annual Inspections Budget Code(s): 10240320-630000 Vendor # 65764
(N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one)New ❑ Renewal
❑ Amendment ❑ Effective Date 8/30/2019 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:
Department nature F2-MB81844C5_� �Vln.� Date: 8/27/2019
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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 insurar---iiocusig A ay----""ations,and requirements:
aCisa
Office of the Risk Management Officer m&6 Date:9/12/2019
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7FDCF9176900498.
Financial Services
This instrument has been pre-audited in the ma17NE5181AMA00
4 �Docusigned by: al Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer . Date: 9/13/2019
Legal Services
This agreement is approved as to legal form and su Docusigned by:
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Office of Fthe County Attorney Date: 9/13/2019
EAA3033E08A805..
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