Orange County NC Website
Browse       Search
DocuSign Envelope ID:66F0044C-A99A-45CE-9996-E7273F35FD53 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Statler Gilfillen Architect Party/Vendor Contact Person: Statler Gilfillen(Statler @outlook.com) <br /> Contact Phone: 919.732.6123 Party/Vendor Address: 3302 St. Mary's Road City Hillsborough State: NC Zip: 27278 <br /> Department: AMS Amount: $690.00 Purpose: Construction administrative services / structural services for Whitted <br /> Lobby service window installation Budget Code(s): 61370035-892000-30012 Vendor # 63294 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ <br /> Effective Date 1/30/17 Approved by Board Yes❑No Agenda Date: <br /> This agreement is approved as to technical form and content: �-DS <br /> Department Director's Signature Date: <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards, specifications,and requirements: <br /> Q(sasCortA{o 1/23/2017 <br /> Office of the Risk Management Office> OeY Date: <br /> ]�DG�O�]66004�8_. <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> DocuSignetl by. <br /> 1/24/2017 <br /> Office of the Chief Financial Office rEl°'N °" °" Date: <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> D sg any: <br /> �,�oLIA, roNr,v{s 1/25/2017 <br /> Office of the County Attorneyt Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecountync.gov <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> Office of the Clerk to the Board Date: <br /> Revised 6/16 4 <br />