HomeMy WebLinkAboutR 2019-703 AMS - Warren Hay Contract Boiler Replacement SHSC DocuSign Envelope ID:7BOB2B82-F1AO-422B-8780-5A55AE1F554A
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: Warren Hay Mechanical Contractors Inc. Party/Vendor Contact Person: Ron LaPann,
(Ron.LaPann(a)Warren-ham) Contact Phone: 919-732-4362 Party/Vendor Address: PO Box 818 City
Hillsborough State: NC Zip: 27278 Department: Southern Human Services Boiler Section 4 Replacement
Amount: Not to Exceed$15,868.00 Purpose: Southern Human Services-Boiler Repair Budget Code(s): 61370035-
800000-30018 Vendor# 25352 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract
Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date 09/30/2019 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:
Department Director's Signature s Q Date:lo/1/zo19
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: N/A
Risk Management
This agreement is approved for sufficiency of insurance standards,specifications,and requirements:
Office of the Risk Management Office QGs�,bn1t f° Date: 10/2/2019
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
P[ Act:
Office of the Chief Financial Officer "` Date:10/2/2019
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney _'� rovh Date:10/2/2019
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 5