R 2016-110-E AMS - Tile Restoration, Inc. for floor restoration in multiple facilities

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DocuSign Envelope ID:07BFB95E-8BDF-4FA6-BB33-1D1B1EEA787C ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Tile Restoration, Inc Party/Vendor Contact Person: Brad Albritton Contact Phone: 866-327- 4600 Party/Vendor Address: PO Box 160, 119 East Main Street City Hookerton State: NC Zip: 28538 Department: AMS Amount: $7760 Purpose: Floor restoration in multiple facilities Budget Code(s): 10240520-630000 Vendor# 61702 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New Renewal❑ Amendment ❑ Effective Date Approved by Board Yes❑No❑ Agenda Date: This agreement is approved as to technical form and content: DocuSigned by: Department Director's Signature Y.# Date: 1/8/2016 9E880A46CF64498... Information Technolosies (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: ''11i1 Office of the Risk Management Officer 9 �,Orvu X16 Date: 1/11/2016 7FDCF9176800498... Financial Services This instrument has been pre-audited in the usigqui4ed by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer 7 Date: 1/13/2016 7D4E 181ACC1409... Legal Services This agreement is approved as to legal form ad s�ffiS� ency: ocu igne y: Office of the County Attorney 56, �� Date: 1/13/2016 EAAMKEDM8465... Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloy(d c�orangecount.nic.Rov 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 1/16 4