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HomeMy WebLinkAboutR 2020-272 AMS - Riley Surveying Whitted sewer route camera inspection DocuSign Envelope ID:4FE3lF34-3D59-4065-92CD-929B08ACFEE8 ORANGE COUNTY—DEPARTMENT USE ONLY Party/Vendor Name: Riley Surveying, P.A. Party/Vendor Contact Person: Jose Torres (itorres@rileysurveyingpa.com) Contact Phone: 919.667.0742 Party/Vendor Address: 3326 Durham Chapel Hill Blvd. Ste B-100 City Durham State: NC Zip: 27707 Department: AMS Amount: $5500.00 (Fixed fee of$5200 and$300 for Reimbursables) Purpose: Whitted Building Complex Storm/Sewer Route Camera Inspection Budget Code(s): 61370035-870000-10028 Vendor#52775 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 4/27/2020 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: Department Director's Signature 5s z QF.,,,k Date:4/23/2020 Agreements for emergency services 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: N/A-No work has been completed. 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 Qt s� �es�n�#fa Date:4/23/2020 Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control P[ Act: Office of the Chief Financial Officer A 4 Date: 4/24/2020 Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney �� Date: 4/2 s/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 9