HomeMy WebLinkAboutR 2020-032 AMS - Racanelli Construction epoxy flooring drain DocuSign Envelope ID: BOOE2CO3-7FB1-43E1-B462-15595673B8DC
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: Racanelli Construction South, Inc Party/Vendor Contact Person: Scott Drebitko
(srebitko(a-)racanelliconstruction.com) Contact Phone: 919.363.3600 Party/Vendor Address: 1001 Pemberton Hill Rd,
Suite 202 City Apex State: NC Zip: 27502 Department: AMS Amount: $4997.00 Purpose: Install eMoxy flooring
from dock area into freezers to address environmental health, and install drainage to remove water from dock Budget
Code(s): 34600020-880000-10076 Vendor#62963 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No
® Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 1/15/20 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:
Department Director's Signature S Qnn�k Date: 1/15/2020
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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 ESO bn1t f° Date:1/15/2020
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Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
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Office of the Chief Financial Officer[ q Date: 1/15/2020
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney Date: 111712020
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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