R 2015-565-E AMS - Concrete Alterations for grinding and sealing concrete floors at 113 Mayo St., DSS expansion

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DocuSign Envelope ID: 36E6A8AF-COF9-489A-B278-380FB6C91329 ORANGE COUNTY-DEPARTMENT USE ONLY DS EG`� Department Party/Vendor Name: Concrete Alterations. Party/Vendor Contact Person: Marcus Yono,VP Contact Phone: 919-851-1352 Party/Vendor Address: 2700 Gateway Centre Blvd, Ste. 650 City Morrisville State: NC Zip: 27560 Department: AMS Amount: $14,250 Purpose: Grinding and sealing concrete floors at 113 Mayo Street. DSS Expansion Budget Code(s): 10240320-570001 Vendor 4 N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New ® Renewal❑ Amendment ❑ Effective Date 10/9/2015 Approved by Board Yes❑No® Agenda Date:N/A This agreement is approved as to technical form an beb�gned by: Department Director's Signature Date:10/13/2015 9E880A46CF64498... 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: DocuSigned""by: ''111L Office of the Risk Management Officer PCs& �,bvvt,e 6 Date: 10/14/2015 7FDCF9176800498... Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Gr�g ned by: Office of the Chief Financial Officer + Date: 10/26/2015 7D4E5181ACC1409... Legal Services This agreement is approved as to legal form and I' j�ed by: Office of the County Attorney Date: 10/27/2015 EJ�A3 Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dollop orangecount.nne.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 10/14 10