2021-163-E Health-Harold V Summey Jr service agreement amendment

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DocuSign Envelope ID:6228C379-87D0-46DE-BCA8-2EFF9ED2282F ORANGE COUNTY—DEPARTMENT USE ONLY Party/Vendor Name: Harold V. Summey,Jr. Party/Vendor Contact Person: Christy Freeman Contact Phone: 336- 417-1816 Party/Vendor Address: 2805 Miller Rd. City Hillsborough State: NC Zip: 27278 Department: Health Amount: $15,000 Purpose: Supply, clean and sanitize portable restrooms and hand washing stations at COVID testing sites Budget Code(s): 10410020-630000-95030 Vendor#62844 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 11/23/20 Approved by Board Yes❑No❑ Agenda Date: This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has not been initiated prior to execution of the agreement: DocuSigned by: LL ,�-�'� nuv Department Director's Signatur ,,16. SI�.+N Date: 12/8/2020 Agreements for emergency services or repair are not subject to the above affirmation. If services related to this agreement have already begun or been completed please briefly describe the nature of the emergency condition that was addressed: Due to pandemic,it was determined that the portable restroom and hand washing station at the COVID test sites should be cleaned and sanitized daily. Information Technologies (Applicable only to hardware/software 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 sufficien fD�ngft% :standards,specifications,and requirements: &0, CbVV,t,{fb 12/8/2020 Office of the Risk Management Office _Fe6F9-1-76aGe"8 Date: Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: DocuSigned by: Office of the Chief Financial Officer lq.-N O.��1. Date:12/8/2020 Legal Services This agreement is approved as t 1,11 Yt�iftdAKd sufficiency:eg l Q kIL kavit, Tmo 12/8/2020 Office of the County Attorney maaanegecnFnFa Date: Clerk to the Board Received for record retention: All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov 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 07/20 10