Orange County NC Website
Browse       Search
DocuSign Envelope ID:298C6E01-9C5E-4A68-8600-AF85E503B99D <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Olive Hill Welding & Fabrication Inc Party/Vendor Contact Person: Josh Dickerson Contact <br /> Phone: 336-592-4411 Party/Vendor Address: 1940 Semora Rd City Roxboro State: NC Zip: 27574 Department: <br /> AMS Amount: $580.00 Purpose: Jail Welding Budget Code(s): 10240320-57000 Vendor # 62580 (N/A if new <br /> vendor) Vendor is a BOCC consultant? Yes ❑ No[] Contract Type: (Check one) New ❑ Renewal ❑ <br /> Amendment ❑ Effective Date 07/01/2019 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 /> Department Director's Signature Oft* L Date: 6/28/2019 <br /> 21EF373AC0454EF.. <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 of inst[&& <br /> DocuSigned by:. ;ifications,and requirements: <br /> Office of the Risk Management Officer L,QVInk&7FDCF0176800408. Date: 6/28/2019 <br /> Financial Services <br /> This instrument has been pre-audited in the man DocuSigned by: Government Budget and Fiscal Control Act: <br /> slJmnR.�w 6/30/2019 <br /> Office of the Chief Financial Officer ` 7NE5181aCC1400. Date: <br /> Legal Services <br /> This agreement is approved as to legal form and DocuSigned by: <br /> �66A, �K6� 7/1/2019 <br /> Office of the County Attorney EAA3D33ED8AW5.. Date: <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 />