R 2016-734 AMS - Scott Haigler Electric DSS building

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DocuSign Envelope ID: D78897AD-7725-4356-86DA-680ODBOE8CC8 ORANGE COUNTY—DEPARTMENT USE ONLY Department PartylVendor Name: Scott Haigler Electric Party/Vendor Contact Person: Scott Haiglcr Contact Phone: 919-479- 9550 PartyNendor Address: 6616 Blalock Rd City Bahama State: NC Zip: 27503 Department: AMS Amount: $5,000.00 Purpose: DSS Electrical Estimate Budget Code(s): 10400130-803000 Vendor # 62639 (hl`/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ❑ Amendment ❑ Effective Date 5/25116 Approved by Board Yes❑No❑ Agenda Date: This agreement is approved as to technic Docusigned by: I fao at. Department Director's Signature Date: 6/2/2016 9E88CA40CF64498... - Information Technologies (applicable only to hardware/softivare purchases or related services)This agreement has been reviewed and is approved as to inforrriation technology content and specifications: Office of the Chief Information Officer Date: Risk Management This agreement is approved for sufficiency of ine,trnnrr+.Onndards,specifications,and requirements: QocuSigned_by:. Office of the Risk Management Officer QUS& (h 6 Date: 6/3/2016 7MCF917E800498... Financial Services This instrument has been pre-audited in ' oocusigned by: ie Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer 41.41/. Date: 6/6/2016 704E5181ACC1409... Ley al Services This agreement is approved as to'°��' `-m °--'---'-ienc : g l}ll Uocusigned by: y �I� LW Office of the County Attorney 8 � Date:6/8/2016 EAAM3aEMAW5 i Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion a Dollo d gran ecoun c. ov I 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 1/16 5