HomeMy WebLinkAboutR 2020-171 AMS - BIRS SHSC repair DocuSign Envelope ID: FF5125CC-D956-4503-BB99-1218A92 DAB F1
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: BIRS, Inc Party/Vendor Contact Person: Mike McClure Contact Phone: 336-574-3060
Party/Vendor Address: PO Box 36197 City Greensboro State:NC Zip: 27416-6197 Department: AMS Amount:Not
to Exceed(One Thousand Three Hundred Seven Dollars and Fifty Nine Cents) $1307.59 Purpose: Reseal Area Drain-
Southern Human Services Budget Code(s): 10240320-570000 Vendor# 57369 (N/A if new vendor) Vendor is a
BOCC consultant? Yes ❑No® Contract Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date
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 Signat fwt �y� Date:3/2/2020
Agreements for emergency servi 2D❑9C❑6e81844C5... 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: Service Call:Address leak above room#116.BIRS Invoice#31540 Job# 15-6358
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 Offi aUSA c4Wt.t& Date: 3/3/2020
DS 7FDCF9176800498...
�L 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 Offic lr7NE5181ACCAH
'� '� Date:3/3/2020
.
Legal Services
This agreement is approved as to leual form and sufficiency:
DocuSigned by'.
Office of the County Attorn 1?C5F3CDDF0B94F6
%f t, �l.Vl v, Date: 3/3/2020
...
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