HomeMy WebLinkAboutR 2020-184 Emergency Svc - CFE Forklift equipment review DocuSign Envelope ID:0460F6DE-D59E-4F27-85AE-25EADBB3FB6B
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: CFE Equipment Corporation, Inc. Party/Vendor Contact Person: Tim Bevilacqua Contact
Phone: 336-668-0959 ext. 518 Party/Vendor Address: 6392 Burnt Poplar Ct. City Greensboro State: NC Zip: 27409
Department: Emergency Services Amount: 500.00 Purpose: PM on forklift 3 times a year plus parts if needed Budget
Code(s): 10750120571000 Vendor # (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No®
Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 03/09/2020 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 t� �� is Date: 3/10/2020
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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:
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 Officer Date:
Financial Services
This instrument has been pre-audited in the manner rec Docusigned by: mment Budget and Fiscal Control Act:
Office of the Chief Financial Officer I 4 � Date: 3/10/2020
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Legal Services
This agreement is approved as to legal form and cuff ' oocusigned by:
Office of the County Attorney •: °' - Date: 3/10/2020
4035CB8304CA4M...
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