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2021-279-Risk Man-NCACC-FY-22 insurance renewals
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2021-279-Risk Man-NCACC-FY-22 insurance renewals
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Last modified
7/2/2021 2:48:19 PM
Creation date
7/2/2021 2:48:13 PM
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Template:
Contract
Date
6/20/2021
Contract Starting Date
6/20/2021
Contract Ending Date
6/22/2021
Contract Document Type
Contract
Amount
$1,242.96
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Revised 07/20 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br /> <br />Party/Vendor Name: NCACC Party/Vendor Contact Person: Charlie Eaton Contact Phone: Party/Vendor Address: City <br />Charlotte State: NC Zip: 28202 Department: Risk Management Amount: Estimated Amount $1,242,958 Purpose: FY21-22 <br />Insurance Renewals Budget Code(s): 10230220 Vendor # 33228 (N/A if new vendor) Vendor is a BOCC consultant? Yes <br />No Contract Type: (Check one) New Renewal Amendment Effective Date 07/01/21 Approved by Board Yes <br /> No Agenda Date: <br /> <br />This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has <br />not been initiated prior to execution of the agreement: <br /> <br /> <br />Department Director’s Signature ________________________________________ 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 /> <br />Information Technologies <br /> <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 /> <br />Office of the Chief Information Officer___________________________________ Date: ________ <br /> <br />Risk Management <br /> <br />This agreement is approved for sufficiency of insurance standards, specifications, and requirements: <br /> <br />Office of the Risk Management Officer___________________________________ Date: _________ <br /> <br />Financial Services <br /> <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br /> <br />Legal Services <br /> <br />This agreement is approved as to legal form and sufficiency: <br /> <br />Office of the County Attorney __________________________________________Date: ________ <br /> <br /> <br />Clerk to the Board <br /> <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 /> <br />Office of the Clerk to the Board __________________________________________Date:_________ <br />DocuSign Envelope ID: 4BC4D079-09BF-4F15-BDA0-A24B1EDE73EF <br />6/20/2021 <br />6/20/2021 <br />6/21/2021
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