R 2016-487-E AMS - Hillsborough Plumbing Co, Inc. to replace water pump and piping

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DocuSign Envelope ID:7C64F6F6-183B-4CE7-90AC-CB4486B1EBD0 ORANGE COUNTY-DEPARTMENT USE ONLY Department Party/Vendor Name: Hillsborough Plumbing Co., INC. Party/Vendor Contact Person: Rob McKee (Mckee o,hillsboroughplumbing com) Contact Phone: 919.732.4506 Party/Vendor Address: 1020 Hwy. 57 N. City Hillsborough State: NC Zip: 27278 Department: AMS Amount: $16,400.00 Purpose: Replace Water Pump and Ri"g Budget Code(s): 61370035-880000-10016 Vendor 9 58196 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 8/23/16 Approved by Board Yes❑No® Agenda Date: This agreement is approved as to technical form and content: D.-��5 g d by: � n Department Director's Signature. Date: 8/23/2016 Information Technologies (Applicable only to hardware/sofrivare 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: D Sy tlby lL(sa �awLCffa Office of the Risk Management Office► Date: 8/24/2016 Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: D 5 g d by: Office of the Chief Financial Officer �";�a 0_41/_ Date: 8/24/2016 C _ , Legal Services This agreement is approved as to legal form and sufficiency: DocuS g d by: Office of the County Attorney 166 )e6buv{s Date: 8/25/2016 Cleric to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@oran ecoun.nc.goy The following signature block is for hard copies only and is not required for Docusign contracts: Revised 6/16 6