HomeMy WebLinkAboutR 2019-747 OCPT - NCDOT FY2020 5311 Grant contract DocuSign Envelope ID:63E81679-OC83-4B6C-B9E4-AFBB81985720
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: NCDOT Party/Vendor Contact Person: Beth Gay Contact Phone: 919.707.4691
Party/Vendor Address: 1501 Mail Service Center City Raleigh State:NC Zip: 27699 Department: Transportation
Services Amount: $174,960 Purpose: Award Amount Budget Code(s): 445002/10435020 Vendor# 14415 (N/A
if new vendor) Vendor is a BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New❑ Renewal ❑
Amendment ❑ Effective Date 10/9 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 Date: 10/9/2019
722E5DDOAB25490 .
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 -oocusigned by, rds,specifications,and requirements:
��tSa �,bV1n.C,{f b 10/10/2019
Office of the Risk Management Officer 7FDCF91769004M. Date:
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act: DocuSigned by:
4 10/11/2019
Office of the Chief Financial Officer 1ACCAN- Date:
Legal Services
This agreement is approved as t DocuSigned by: -,iency:
�c t,S NA, 10/11/2019
Office of the County Attorney 328DC48n549A4F5.. Date:
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