HomeMy WebLinkAboutR 2019-649 AMS - Tommy Lawrence BOE floodlight repair DocuSign Envelope ID:C77C009B-6809-4BD1-87DB-D92DA2E2365E
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Tommy Lawrence Electrical Contractors, Inc Party/Vendor Contact Person: Warren Tam
Contact Phone: 336-599-4771 Party/Vendor Address: PO Box 641 City Roxboro State:NC Zip: 27573 Department:
ams Amount: $750.00 Purpose: BOE Flood Light Budget Code(s): 10240320-570001 Vendor# 58196 (N/A if new
vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ❑
Amendment ❑ Effective Date 9/1/2019 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 Director's Signature S&W, AMA Date:9/24/2019
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 insuran&&A&&ids, specifications,and requirements:
Q�tSA, CbVYn,t b
Office ofr the Risk Management Officer Date:9/24/2019
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in the manner re..0 . n ,yb�e Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer 0..,44. Date:9/24/2019
7D4E5181ACC1409...
Legal Services
This agreement is approved as to legal form hs�,4fi�'4
Office of the County Attorney FAAsnssFnAA8465 Date: 9/24/2019
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