2016-504-E AMS - Tibbens Construction for CGCC upgrade window

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DocuSign Envelope ID: E8CB95E7-533C-49AF-92F5-8C9FC602256D ORANGE COUNTY-DEPARTMENT USE ONLY Department Party/Vendor Name: Tibbens Construction Party/Vendor Contact Person: Mark Tibbens tibbensconst @aol.com Contact Phone: 919.667.5366 PartyNendor Address: 849 Moose Tracks Trl. City Cedar Grove State:NC Zip: 27231 Department: AMS Amount: 790.00 Purpose: CGCC Upgrade Window Budget Code(s): 61370035-880000-10016 Vendor# 63556 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New® Renewal❑ Amendment ❑ Effective Date June 10,2016 Approved by Board Yes No Agenda Date: This agreement is approved as to technical form and content: ,—Us Department Director's Signature Date: ,Qb 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: Uoc 59 dby Office of the Risk Management Office QUsa C611"6 Date: 6/8/2016 �,dbdo gib_ Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: U 5'9 dby 8/25/2016 Office of the Chief Financial Officer to 0 r. -5,3 ACC MO Date: Legal Services This agreement is approved as to legal form and sufficiency: i—UOCU5i9ned by: Office of the County Attorney ,)0L'''" 'hwts Date: 8/25/2016 Clerk to the Board 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: Revised 6/16 4