HomeMy WebLinkAboutR 2020-143 AMS - Pine Shore Energy EV charging station replacements DocuSign Envelope ID:82EFC9DB-7D47-4E7B-9162-C9CE62D9862C
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Pine Shore Energy LLC Party/Vendor Contact Person: David Thompson, Contact Phone:
336-893-6213 Party/Vendor Address: 131 Fayette St. City Winston-Salem State: NC Zip: 27101 Department:
Asset Management Services Amount: $89,335.07 Purpose: Grant-funded electric vehicle charging station
replacements. Budget Code(s): 30240030-800000-71321 Vendor # 65135 (N/A if new vendor) Vendor is a
BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective
Date February 18th,2020 Approved by Board Yes®No❑ Agenda Date: September 3,2019
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 Date: 2/20/2020
Agreements for emergency services or o6wtiotbj.ect 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 insurance standards,specifications,and requirements:
DocuSigned"by:
'
Office of the Risk Management Officerriusa, r,OV1n t . Date: 2/20/2020
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act:
DocuSigned by:
Office of the Chief Financial Officer F0,., Date: 2/20/2020
7NE5181ACC1409...
Legal Services
This agreement is approved as to legal form and sufficiency:
DocuSigned by:
Office of the County Attorney 5� Date: 2/24/2020
4C5F3CDDF0B94F6...
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
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DocuSign Envelope ID:82EFC9DB-7D47-4E7B-9162-C9CE62D9862C
Revised 11/19
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