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

Browse Search

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 Party/Vendor 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: Department Director's Signature Date: Q� Information Technologies (Applicable only to harchvare/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 9 dby: Office of the Risk Management Office ZS 5(,awu.flo Date: 6/8/2016 Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Uoc 5'9 dby: Office of the Chief Financial Officer Date: 8/25/2016 Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney[°(ti 9�ohwts Date: 8/25/2016 Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecogElync.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