R 2016-169-E AMS - Tac Welding to repair drain doors at Animal Services

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DocuSign Envelope ID: D5D06FFD-4F06-41F3-995C-9CC783787299 ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Tac Welding Party/Vendor Contact Person: Tyler Dean Contact Phone: (919) 886-3727 Party/Vendor Address:4816 High Rock Rd City Efland State:NC Zip:27243 Department:AMS Amount:$4,500.00 Purpose:Animal Sery Drain Doors Budget Code(s): 10240320-57000 Vendor#63549 (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: Signed by: Docu Department Director's Signature +L Date:-2y237 1fr16 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: DocuSig/'ned""by: ''��.�.. Office of the Risk Management Officer Pusa, r,Orv�c,i16 Date: 7FDCF9176800498... 2/24/2016 Financial Services This instrument has been pre-audited in the> oau ,e squired by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer (� `�°'�"��°'L Date: 7D4E5181ACC1409... 2 2_4T2_0 16 Legal Services This agreement is approved as to legal form and sufficiency: DocuSigned by: Office of the County Attorney 6 In, r6ufs Date: EAAMKEDM8465... 2/26/2616 Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dollo d a,oran eg coun nc, ov 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 4