HomeMy WebLinkAboutR 2019-790 AMS - Riley Surveying utility survey Efland ES station DocuSign Envelope ID:9DC16EAB-77D3-4316-AF4C-969A33AE3003
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: Riley Surveying P.A. Party/Vendor Contact Person: Phillip W. Riley
(philr(a-)rileysurveyingpa.com) Contact Phone: (919)667-0742 Party/Vendor Address: 3326 Durham Chapel Hill
Blvd. Suite B-100 City Durham State: NC Zip: 27707 Department: AMS Amount: $2450 Purpose: Efland
Stand-A-Lone Topographic Survey Utility Update including septic Budget Code(s): 61370035-870000-10053
Vendor#52775 (N/A if new vendor) Vendor is a BOCC consultant? Yes ®No❑ Contract Type: (Check one)
New ® Renewal ❑ Amendment ❑ Effective Date 11/l/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:
10/23/2019
Department Director's Signature "" ���S Date:
CsP
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
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 insurance standards,specifications,and requirements:
Office of the Risk Management Office QGs� �e���#f° Date:10/23/2019
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Fz Act:
Office of the Chief Financial Office " Date: 10/23/2019
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney �' ` Date: 10/25/2019
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
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