Orange County NC Website
Browse       Search
DocuSign Envelope ID:6228C379-87D0-46DE-BCA8-2EFF9ED2282F <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Harold V. Summey, Jr. Party/Vendor Contact Person: Christy Freeman Contact Phone: 336-417-1816 <br /> Party/Vendor Address: 2805 Miller Rd. City Hillsborough State: NC Zip: 27278 Department: Health Amount: $20,000 <br /> Purpose: Supply, clean and sanitize portable restrooms and hand washing stations at COVID testing sites Budget Code(s): <br /> 10410020-630000-95030 & 95034 Vendor# 62844 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® <br /> Contract Type: (Check one)New ❑ Renewal ❑ Amendment ® Effective Date 2-22-21 Approved by Board Yes❑No <br /> ❑ Agenda Date: <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this <br /> project has not been initiated prior to execution of the agreement: <br /> DocuSigned by: <br /> iln Aanai Sft ayf 2/18/2021 <br /> Department Director's Signatur Date: <br /> Agreements for emergency services or repair are not subject to the above affirmation. If services related to this agreement have <br /> already begun or been completed please briefly describe the nature of the emergency condition that was addressed: <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is approved as to <br /> information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficienc tandards, specifications,and requirements: <br /> ulTb <br /> Office of the Risk Management Officerr277 <br /> Date: 2/18/2021 <br /> Financial Services <br /> This instrument has been pre-audited y the Local Government Budget and Fiscal Control Act: <br /> +� 3/22/2021 <br /> Office of the Chief Financial Officer Date: <br /> Legal Services <br /> This agreement is approved as to f� d*sl sufficiency: <br /> Qkkit, M. rit, t6SCb 3/22/2021 <br /> Office of the County Attorney azaaae� seFaF' Date:_ <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@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 February 2021 <br />