HomeMy WebLinkAboutR 2019-665 Planning - Wellsmont SCS 3 mowing DocuSign Envelope ID:A780FCDD-F9F7-4EE5-AE8F-E6AF76883C38
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: $1,150.00 Purpose: FY19-20 Mowing at Sediment Control Structure No. 3 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 September 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:
Sig—by 9/18/2019
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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:
° 91g tley 9/23/2019
Office of the Risk Management Officer[Q�Sa-Emu fb,,00 .00 Date:
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
5g by: 9/24/2019
Office of the Chief Financial Officer Date:
i 91E5181AE61<BB
Legal Services
This agreement is approved as to legal form and sufficiency:
r° 5'gned by:
9awt
Office of the County Attorney l BEBE6,B3by�aw�5 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