HomeMy WebLinkAboutR 2019-912 AMS - Brown Brothers Passmore Center water line repair DocuSign Envelope ID: F1B32247-7AA8-4384-AB50-83A2F9738D07
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Brown Brothers Plumbing & Heating Co, Inc Party/Vendor Contact Person: Jeff Addison
Contact Phone: 919-220-2551 Party/Vendor Address: 2820 North Roxboro Rd City Durham State: NC Zip: 27704
Department: AMS Amount: $4592.00 Purpose: Passmore cold water line repair Budget Code(s): 10240320-570000
Vendor# 35730 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one)
New ❑ Renewal ❑ Amendment ❑ Effective Date 12/23/2019 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 �� "A Date:12/12/2019
2DD9CD6681844C5.
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:
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-----D-o-c„si9ppneQa_ay:.�6---ifications,and requirements:
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Office of the Risk Management Officer Usa L Date: 12/16/2019
7FDCF9176800498.
Financial Services
This instrument has been pre-audited in the manne Docusigned by: ovemment Budget and Fiscal Control Act:
('� 12/16/2019
Office of the Chief Financial Officer 7D4E51s,acc,4os. Date:
Legal Services
This agreement is approved as to legal fo DocuSigned by:
�bL&I Pkk l 5 12/16/2019
Office of the County Attorney EA AM3sEDsaa4s5.. 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 11/19 4