HomeMy WebLinkAboutR 2020-146 Solid Waste - American Industrial HVAC repair DocuSign Envelope ID:7EF04F9E-81 E3-46C4-l358E-2A08DD460FC4
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: American Industrial Contractor, Inc. Party/Vendor Contact Person: JAKE N JOHNSTON
Contact Phone: (336) 213-4489 Party/Vendor Address: PO Box 16224 City Greensboro State: NC Zip: 27406
Department: Solid Waste Amount: 12,796.00 Purpose: Replace One HVAC system Budget Code(s): 50350020-
570000 Vendor# 59312 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type:
(Check one)New ® Renewal ❑ Amendment ❑ Effective Date 2-10-2020 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:
nature w l� AS 2/24/2020
Department Director's Si Date:Agreements for emergency services or__ ssEssi sasssoass... _o 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 Officer Qusa. (,DV1n 6 Date:2/24/2020
7FDCF0176800408...
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act:
Docu5igned by:
Office of the Chief Financial Officer 2/25/2020
`�' '� Date:
704E51S1ACC1409...
Legal Services
This agreement is approved as to legal form and sufficiency:
DocuSigned by:
Office of the County Attorney �p , hmv, Date: 2/25/2020
4C5FKDDF0694F8...
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:7EF04F9E-81E3-46C4-B58E-2A08DD460FC4
Revised 11/19
10