R 2014-576 AMS - FloorChem, Inc. to install opoxy flooring at the jail $12,767

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DocuSign Envelope ID: 332006D6 -447D- 4529- A8C4- 6OE3494C993D ORANGE COUNTY — DEPARTMENT USE ONLY Department Party/Vendor Name: F1oorChem, Inc Party/Vendor Contact Person: Anita M. Brack, Owner Contact Phone: 919 -854- 9776 Party/Vendor Address: 200 Powell Drive, Ste 103 City Raleigh State: NC Zip: 27606 Department: Asset Management Services Amount: $12,767 Purpose: Install opoxy flooring at t the jail Budget Code(s): 10240320 - 570001 Vendor # 57002 (N /A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date December 1, 2014 Approved by Board Yes❑ No❑ Agenda Date: This agreement is approved as to technical,gmg"pntent: ,// Department Director's Signature 5; '.110°f111 Date: 12/6/2014 9E88OA46CF6449&- 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 Risk Management Date: This agreement is approved for sufficienc ig,%vi g ""g„s''ta�ndards, specifications, and requirements: ausa, r,6vvte tt0 12/8/2014 Office of the Risk Management Officer Date: FB�FrtJ'17695fi49 ... Financial Services This instrument has been pre - audited in maniux�,quired by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer I ,)_ uVR Date: 12/8/2014 2F982EC44=444... Legal Services This agreement is approved as to ^ Aol: sufficiency: Office of the County Attorney �b Oufs Date: 12/8/2014 Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@oran eg countync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Cleric to the Board Date: Revised 10/14 4