HomeMy WebLinkAboutR 2020-219 AMS - Drain Express Inc. EAC drain DocuSign Envelope ID:7249DADO-19FF-4COE-88F9-EA556OE34ED7
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: Drain Express, Inc Party/Vendor Contact Person: Dickie Atkinson (drainexp(a),bellsouth.net)
Contact Phone: 919-968-0070 Party/Vendor Address: PO Box 670 City Carrboro State:NC Zip: 27510 Department:
AMS Amount: $1633.95 Purpose: EAC (306 Revere Road) sewer line cleanout Budget Code(s): 10240320-570000
Vendor# 60409 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)
New ® Renewal ❑ Amendment ❑ Effective Date 02/07/2020 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:
DS
UocuSigned by:
Department Director's Signatu Es!= ey►n Date
Agreements for emergency servic6681844C5... 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: Emergency due to facility maintenance was unable to clear the sewer line with the equipment that they had.
The facility was without a toliet and sink,help was called out to fix the problem so the employees would have a
working bathroom.
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 sufficiencv of insurance standards, specifications,and requirements:
C91DocuSigned by:
sa / ,
7FDCF9176900498
UOffice of the Risk Management Offic L46Date: 3/20/2020
...
D.S
r Financial Services
l/ This instrument has been pre-audited i^tko usg�ea av P"i—I 1"i the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Office C 1.t�j Date:3/22/2020
7NE5181ACC1469...
Legal Services
This agreement is approved as to legal form and sufficiency:
DocuSigned by:
Office of the County Attorn[� � �t
6mv, Date:3/22/2020
4C5F3CDDF0694F6...
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