R 2016-119-E AMS - Tibbens Construction for Board of Elections renovations

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DocuSign Envelope ID: 13936B85-84DF-43F8-8F41-517DO73AODA8 ORANGE COUNTY—DEPARTMENT I.1SE ONLY Department Party/Vendor Name: Tibbens Construction PartyNendor Contact Person: IN lark Tibbens Contact Phone: 919 643- 2856 PartyNendor Address: 849 Moose Tracks Trl. City Cedar Grove St,ite: NC Zip: 27231 Department: AMS Amount: $16,600.00 Purpose: BOE Renovations Budget Code(s): 61370035-380000-10042 Vendor#63556 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract T,rpe: (Check one) New ❑ Renewal ❑ Amendment ❑ Effective Date Approved by Board Yes❑No❑ Agenda Date: This agreement is approved as to technical form 9d content: 5i;uSigne by: Department Director's Signature 74o.1,00"' Date: 9E880A46CF64498... 1/19/2016 Information Technologies (Applicable only to hardware/software purchases or Belated 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: Docu5ig/'ned"by: '�.�. Office of the Risk Management Officer Pausa, r,OV't td 6 Date: 7FDCF9176800498... 1/19/2016 Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: DocuSigned by: Office of the Chief Financial Officer Date:-1/20/ 16 7D4E5181ACC1409... Legal Services This agreement is approved as to le foan aid sufficiency: ocu Igoe y: Office of the County Attorney Jb Date: EAA3D33ED8A8465... 1120 2016 Clerk to the Board l Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@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: i i I Revised 10/14 4