HomeMy WebLinkAboutR 2020-213 Planning - In Water Services gate stem DocuSign Envelope ID:2E2387F3-3A58-44C5-A8FF-30C659A8AB71
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: In-Water Services, Inc. Party/Vendor Contact Person: Mike Brian Contact Phone: 336-272-
5500 Party/Vendor Address: 3638 SE School Road City Greensboro State:NC Zip: 27406 Department: Planning
Amount: $6,498.00 Purpose: Fabrication and Installation/Testing of Sluice Gate Stem Guides Budget Code(s):
$1,499.00 will be billed to #61370035-880000-10074 (CIP); $4,999.00 will be billed to #10695020-720013
(Operations) Vendor#65918 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type:
(Check one)New ® Renewal ❑ Amendment ❑ Effective Date March 20,2020 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:
❑ocusigned by:
P g � l _�t.�«f 3/19/2020
Department Director's Signature Date:
Manlrnnx.=na:�
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:
❑ S'8 d hy:
1�Sa fan 6 3/19/2020
Office of the Risk Management Office Date:
[__
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
❑ Sig c by:
3/19/2020
Office of the Chief Financial OfficerI Date:
f M1=51R1ACC11[%i
Legal Services
This agreement is approved as to legal form and sufficiency:
❑ S'8 d hy:
Office of the County Attorney1XMts �"L'' Date:3/19/2020
W,1n'A@0UWA4F,
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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