R 2016-713-E AMS - Owens Roofing Inc. for roof repairs at DA and BOE Bldgs.

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DocuSign Envelope ID: C55312FA-A914-492C-8FAD-C8F94AB43B19 ORANGE COUNTY-DEPARTMENT USE ONLY Department Party/Vendor Name: Owens Roofing Inc. Party/Vendor Contact Person: Bert Owens(Bert&owensroofinginc.com) Contact Phone: 919-821-0082 Party/Vendor Address: 301 West Cabarrus St City Raleigh State: NC Zip: 27601 Department: AMS Amount: $2200.00 Purpose: Roof Repairs DA& BOE Buildings Budget Code(s): 61370035- 882000-30002 Vendor# 40199 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date 1/5/17 Approved by Board Yes❑No ® Agenda Date: This agreement is approved as to technical forth and content: Do Department Director's Signature Date: 12/28/2016 Information Technolosies (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: ..........by: Office of the Risk Management Office aGsa�owu.lfo Date: 12/28/2016 Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: D Sib-d by: Office of the Chief Financial Officer Date: 12/29/2016 Legal Services This agreement is approved as to legal forth and sufficiency: � 9 Office of the County Attorney olun,r6 Date: 12/30/2016 Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloy(d c�orangecount.plc.gov The following signature block is for hard copies only and is not required for Docusign contracts: Revised 6/16 6