HomeMy WebLinkAboutR 2019-641 DEAPR - Summey Portable Restrooms waste disposal restroom trailer DocuSign Envelope ID: E7280C15-9FB3-4lA8-848B-04166A2932E2
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: Summey Portable Restrooms Party/Vendor Contact Person: Christy Freeman Contact Phone:
336-417-1816 Party/Vendor Address: 2805 Miller Road City Hillsborough State: NC Zip: 27278 Department:
DEAPR Amount: $3,375 Purpose: Waste Disposal of Restroom Trailer Budget Code(s): 6300000 Vendor# 62844
(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 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:
awlDocuSigned by:Department Director's Signature1P.,
gawa Date: 9/11/2019
1CFA1D507A405..
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 sufficienc -Diocusigned by: 'ds, specifications,and requirements:
Musa (ham 6 9/16/2019
Office of the Risk Management Officer 7FDCF9176800498. Date:
Financial Services
This instrument has been pre-audited i DocuSigned by: the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer I 411-, Date:9/17/2019
7D4E5181ACC1400. -
Legal Services
This agreement is approved as to DocuSigned by: ciency:
�bLW Pkku s 9/18/2019
Office of the County Attorney Date:
El+A3D33ED8AE4S5..
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:
r[Ds
Revised 12/18 4 VJ