R 2016-743 AMS - Penn Davis Coatings EMS painting

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DocuSign Envelope ID:24485349-1FD8-49B0-AAD2-75C7D446130C ORANGE COUNTY—DEPARTMENT USE ONLY Department PartyNendor Name: Penn-David Coatings, Inc Party/Vendor Contact Person: Jeff Cook Contact Phone: 919-779- 0271 PartyNendor Address:PO Box 575 City Garner State:NC Zip: 27529 Department: AMS Amount:S3,520.0 Q Purpose: EMS REVERSE PAINTING Budget Code(s): 10240320-570001 Vendor # 61197 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No[] Contract'Type: (Check one) New ❑ Renewal ❑ Amendment ❑ Effective Date Approved by Board Yes[]No❑ Agenda Date: This agreement is approved as to terl-- r I ',••^, ^A^^^"°nt: lap Iocusigned by: Department Director's Signature `�� 7A'O'V °" Date:9/16/2016 9E88CA48CF64498 Information Technologies (applicable only to hardwarelsoftware 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 sufficienev of insurance standards,specifications,and requirements: Docu5igned by: Office of the Risk Management Office 161, Cb�6 . s_ Date9/16/2016 7FDCF9176800498.-. Financial Services This instrument has been pre-audited i oocusigned by: he Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer Date:9/16/2016 - 7NE5181ACC1409.-. — ----— Legal Services This agreement is approved as t( ' DocuSigned by:' "iciency: Office of the County Attorney I kA bLW K Date:9/16/2016 EAAM33ED8AW5-.- Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ DollaxdP—orangecountyne.gov j 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 5