HomeMy WebLinkAboutR 2019-798 AMS - National Power SHSC generator DocuSign Envelope ID:4E53090E-A748-43C6-844B-8DDCC37F7E28
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: National Power Party/Vendor Contact Person: Brent Horton Contact Phone: 919-790-1672
Party/Vendor Address: 4541 Preslyn Dr City Raleigh State: NC Zip: 27616 Department: AMS Amount: 439.25
Purpose: Southern Human Services Generator repair-added Oil Budget Code(s): 10240320-570000 Vendor # 57533
(N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one)New ❑ Renewal
❑ Amendment ❑ Effective Date 9/26/2019 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 12DD9CD6B81844C5_
im• 9MA Date: 10/28/2019
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: Generator for Southern Human Services was out of service due to low fluids.Expedited to have generator in
service.
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 DocuSigned by: ifications,and requirements:
[USA, L,QVIn�,{�b 10/28/2019
Office of the Risk Management Officer 7FDCF9176800498. Date:
Financial Services
This instrument has been pre-audited in the manner DocuSigned by: �vemment Budget and Fiscal Control Act:
10/28/2019
Office of the Chief Financial Officer 7D4E5,a,acc,aos. Date:
Legal Services
This agreement is approved as to legal form an [DocuSigned by:
Office of the County Attorney 6� K6 Date:10/28/2019
EAA3033E08A84S5..
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