Orange County NC Website
Browse       Search
DocuSign Envelope ID: D532D6C8-D6FD-42D6-9F88-CF4FDECD6C1F - — - <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: 101 Mobility NC Triangle Metro Area PartyNendor Contact Person: Mine Spears Contact <br /> Phone: 919-500-8667 PartyNendor Address: 3209 Gresham Lake Road, Suite_106 City Raleigh State: NC Zip: <br /> 27615 Department: Social Services Amount: $3,830.23 Purpose: provision&installation of stairlift Budget Gode(s): <br /> 10400220-622000 Vendor#N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract <br /> Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 3/6/2020 Approved by Board Yes❑No <br /> ® Agenda Date: <br /> This agreement is approved as to technical form and conterit-and I as Department Director affirmatively state work on <br /> this project has not been initiated prior to execution of the agreement: <br /> UocuSignedd�by, <br /> Department Director's Sign ('6 w Date: 3/11/2020 <br /> g �AE1 E196AM455... <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 hardwarelsoftware 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 sufficienc- `Docusignedby:` -'ds,specifications,and requirements: <br /> aUSX (,41^ln.t 6 3/10/2020 <br /> Office of the Risk Management Officer Date: <br /> 7F6CF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in oocusigned by: the Local Government Budget and Fiscal Control Act: <br /> 3/12/2020 <br /> Office of the Chief Financial Officer 7oaE51siacc,aas... Date: <br /> Legal Services <br /> This agreement is approved as t OocuSigned by: ncy: <br /> &,__ 3/12/2020 <br /> Office of the County Attorney gp35C68304CA4A9... rate: <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 11/19 4 <br />