HomeMy WebLinkAboutR 2019-793 AMS - Warren Hay Electrical Library boiler gas leak DocuSign Envelope ID:740BA81E-87D3-43AA-B2AC-DB756387E9EC
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: Warren-Hay Party/Vendor Contact Person: Ron LaPann Contact Phone: 919-732-4362
Party/Vendor Address: PO Box 818 City Hillsborough State: NC Zip: 27278 Department: AMS Amount: $287.50
Purpose: Library Boiler Gas Leaks Budget Code(s): 10240320-570000 Vendor # 25352 (N/A if new vendor)
Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ❑ Amendment ❑
Effective Date 9/21/2019 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 Siw• kmh Date: 10/17/2019
Agreements for emergency services or repair are nui°uojeCL LO n aoove 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: Per Paul Sorrell,Received a phone call on a Saturday morning from fire marshal that Dominion energy
located leaks at boilers that operate library.Maintenance does not stock 1.5 fittings therefore Warren Hay was called to
complete job and return the boilers back into operation.Library can not operate without the use of boilers.
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 insu Docusianed_by: ifications,and requirements:
sa �AV1n.�.�b 10/23/2019
Office of the Risk Management Officer 7F❑CF9176900498. Date:
Financial Services
This instrument has been pre-audited in the mar Docusigned by: 1 Government Budget and Fiscal Control Act:
10/23/2019
Office of the Chief Financial Officer 7D4E5181A=400. Date:
Legal Services
This agreement is approved as to legal form 0DEAA3D3aED&AW5_
Docusigned by:
Office of the County Attorney 6LW �bk� Date10/24/2019
.
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 4