Orange County NC Website
Revised 07/20 4 <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br />Party/Vendor Name: Green Build LLC Party/Vendor Contact Person: John Clark (clarkjr68@gmail.com) Contact <br />Phone: 919-697-0738 Party/Vendor Address: 605 Kenion City Hillsborough State: NC Zip: 27278 <br />Department: AMS Amount: Fiscal Year 21/22: $2954.40 Purpose: To build and install a new glass window with pass <br />through box in the Magistrates Office at the New Courthouse Room 109 Budget Code(s): 10240320570001 Vendor <br /># (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New <br />Renewal Amendment Effective Date 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 />Department Director’s Signature ________________________________________ Date: ________ <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 insurance standards, specifications, and requirements: <br />Office of the Risk Management Officer___________________________________ Date: _________ <br />Financial Services <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br />Legal Services <br />This agreement is approved as to legal form and sufficiency: <br />Office of the County Attorney __________________________________________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 />DocuSign Envelope ID: EBAFF4D7-2BAE-4809-B2AB-307803B9F36E <br />6/16/2021 <br />6/17/2021 <br />6/25/2021 <br />6/25/2021