HomeMy WebLinkAboutR 2019-784 AMS - Carolina Restoration Services RENA water mitigation DocuSign Envelope ID:54B72E39-BDA8-4BB5-A805-8F99E054CB43
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: Carolina Restoration Services of North Carolina,Inc. Party/Vendor Contact Person: Phil Rhodes
Contact Phone: 919-469-1955 Party/Vendor Address: 3401 Gateway Centre Blvd. City Morrisville State: NC Zip:
27560 Department: AMS Amount: $1,289.71 Purpose: RENA Emergency Water Mitigation Budget Code(s):
10240320-570000 Vendor# 63827 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract
Type: (Check one)New ❑ Renewal ❑ Amendment ❑ Effective Date 8/20/2019 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:9/19/2019
2DD9CDBB81844C5.
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: Emeregncy water/sewage mitigation from sewage back up caused by failed pump.
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 sufficient of insur---- ----=fications and requirements:
g pp y i]ocusigned by: � q
Office of the Risk Management Officer U$6. �,b b Date:10/22/2019
7FDCF9176800498.
Financial Services
This instrument has been pre-audited in the7E7NE5181ACC1409
Docusigned by: Government Budget and Fiscal Control Act:
11-N
Office of the Chief Financial Officer Date:10/22/2019
. — -
Legal Services
This agreement is approved as to legal f DocuSigned by:
�6� K6 Y S 10/22/2019
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