HomeMy WebLinkAboutR 2020-278 Emergency Svc - PLM Equipment stretcher maintenance DocuSign Envelope ID:294BB418-E1F3-4C25-885F-5006334D0849
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: PLM Equipment Services Party/Vendor Contact Person: Pam Mims Contact Phone: 919-
233-2231 Party/Vendor Address: 212 Powell Dr Suite 122 City Raleigh State: NC Zip: 27606 Department:
Emergency Services Amount: $6,085.00 Purpose: Equipment maintenance for ambulances Budget Code(s):
10757520-571000 Vendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract
Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date April 30, 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:
UocuSigned by:
Department Director's Signature Date: 5/3/2020
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 required by the Local Government Budget and Fiscal Control
Act: �ocu5igned by:
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Office of the the Chief Financial Officer 7o4E5�s1ACC1409... Date: 5/5/2020
LeEal Services
This agreement is approved as to legal form and suffic Oocusigned dy:
5/5/2020
Office of the County Attorney Date:
4635C68304CA4M...
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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