R 2017-719-E AMS - Mebane Air Dickson House HVAC

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DocuSign Envelope ID: B45C8196-4DA8-42AE-9309-8DBF33AFC945 ORANGE COUNTY-DEPARTMENT USE ONLY Department Party/Vendor Name: Mebane Air, Inc. Party/Vendor Contact Person: Timothy Braddy (mebaneair@,mebtel.net) Contact Phone: 919.563.2093 Party/Vendor Address: 718 Mattress Factory Road City Mebane State: NC Zip: 27302 Department:AMS Amount: 9,447.10 Purpose:Replace the existing HVAC equipment at the Dickson House due to existing equipment at end of life. Budget Code(s): 61370035-880000-30018 Vendor#40609 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 12/21/17 Approved by Board Yes❑No® Agenda Date: This agreement is approved as to technical form and content: Department Director's Signature Date: 12/18/2017 Asset Management (Applicable only to construction contracts)This agreement has been reviewed and is approved as to construction services content and specifications: Office of the Asset Management Directo Date:12/18/2017 Risk Management This agreement is approved for sufficiency of insurance standards,specifications,and requirements: a. Office of the Risk Management Officer[G �O'��#f° Date:12/18/2017 Financial Services Pz This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer 1_4 Date:12/19/2017 Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney ��l�la�rf s Date: 12/19/2017 Cr-n-RA3 P. Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydkorangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Revised 10/17 6