Orange County NC Website
DocuSign Envelope ID: F772F57D-CDB6-49D8-AED6-68B334B4C6C6 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Bonitz Flooring Party/Vendor Contact Person: Tiffany Brewer Contact Phone: 919-599-3811 <br /> Party/Vendor Address: 10701 World Trade Blvd. City Raleigh State: NC Zip: 27617 Department: Health Amount: <br /> 4 805.00 Purpose: Carpet new Navigator office Budget Code(s): 61370035-892000-30012 Vendor#N/A (N/A if <br /> new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ <br /> Amendment ❑ Effective Date 6-5-19 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work on <br /> this project has not been initiated prior to execution of the agreement: <br /> DocuSigned by: <br /> S�_Wo 5/31/2019 <br /> Department Director's Signature Date: <br /> 3C16F2D09E3445F. <br /> Agreements for emergency services or repair are not subject to the above affirmation. If services related to this <br /> agreement have already begun or been completed please briefly describe the nature of the emergency condition that was <br /> addressed: <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- -roocuSgned by-:- -'-­ds, specifications,and requirements: <br /> Office of the Risk Management Officer aCt$a (��6 Date: 6/10/2019 <br /> 7FDCF9176800498. <br /> Financial Services <br /> This instrument has been pre-audited:Ir <br /> Docusigned by: the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Office 4 � Date:6/10/2019 <br /> 7NE5181 ACC 1469. <br /> Legal Services <br /> This agreement is approved as tc Docusigned by: <br /> �KAZ ftayif, 6/10/2019 <br /> Office of the County Attorney Date: <br /> 079A40525C0F4FB. <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@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 12/18 4 <br />