Orange County NC Website
ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br />Party/Vendor Name: Walker Automotive Supply, Inc. Party/Vendor Contact Person: John Kelley Contact Phone: <br />919-995-6635 Party/Vendor Address: PO Box 19348 City Raleigh State: NC Zip: 27619 Department: <br />AMS/OCPT Amount: $55,617 Purpose: Annual Parts Supplier Budget Code(s): 10240320-630000 (40%), <br /> Vendor is a <br /> Effective <br />10240520-630000 (10%), and 10435120-630000 (50%) Vendor # 58664 (N/A if new vendor) <br />BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment <br />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 <br />on 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 <br />was 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 <br />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 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 12/18 8 <br />DocuSign Envelope ID: 5ED1BC94-D5AC-4571-96DF-1227F25A4277 <br />8/25/2021 <br />8/31/2021 <br />9/13/2021 <br />9/13/2021