HomeMy WebLinkAboutR 2019-785 DEAPR - Poythress Tents Spooktacular rental DocuSign Envelope ID:5F379893-6C3D-49CA-AAAA-1A8324084F83
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: Poythress Tents, Tables & Chairs Party/Vendor Contact Person: David Po. Kress Contact
Phone: 336-446-0434 Party/Vendor Address: PO Box 55 City Gibsonville State: NC Zip: 27249 Department:
DEAPR-Recreation Amount: $1,804.08 Purpose: Tent Rental Budget Code(s): 10511020-630000 Vendor #
(N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New ® Renewal
❑ Amendment ❑ Effective Date 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:
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�f��L DocuSigned by: r
Department Director's Signature Date:10/21/2019
611CFA1D507A495..
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: David Stancil,DEAPR Director
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:
."� ' ids,specifications,and requirements:
aUsa (D b 10/22/2019
Office of the Risk Management Officer 7FDCF9176800498. Date:
Financial Services
This instrument has been pre-audited ii Docusigned by: the Local Government Budget and Fiscal Control Act:
4 10/22/2019
Office of the Chief Financial Officer ` 7D4 81AMA09. Date: _
Legal Services
This agreement is approved as tc Docusigned by: _iciency:
Office of the County AttorneyD6LW �bk� Date: 10/22/2019
EAA3MaEMAW&—
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
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