HomeMy WebLinkAboutR 2019-759 AMS - William Smith Masonry justice center brick wall DocuSign Envelope ID:9DFOE4B9-6D1E-4361-9820-05E21BC05405
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: William E. Smith Masonry, Inc Party/Vendor Contact Person: Tiffany Smith Bennett Contact
Phone: 919-321-1814 Party/Vendor Address: 1818 Marion's Ford Road City Chapel Hill State: NC Zip: 27516
Department: AMS Amount: $300.00 Purpose: New Courthouse Stone Wall Cap Repair Budget Code(s): 10240320-
570000 Vendor#65715 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No❑ Contract Type: (Check
one) New ❑ Renewal ❑ Amendment ❑ Effective Date 10/20/2019 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 �� 9MA Date:10/15/2019
2DD9CD6681844C5.
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 ine------D-oc-usi9ned by:'" --,cifications,and requirements:
Office of the Risk Management Officer U$6. �,bVln.t,{�6 Datc:10/15/2019
7FDCF9176800498.
Financial Services
This instrument has been pre-audited in the ma Docusigned by: d Government Budget and Fiscal Control Act:
10/15/2019
Office of the Chief Financial Officer 7D4E5181.acCAN. Date:_ _
Legal Services
This agreement is approved as to legal form C
DocuSigned by:b� Pk� 10/16/2019
Office of the County Attorney EAA3D33ED8AW5.. 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 4