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DocuSign Envelope ID: 119AF03D-E3CO-4FO2-B437-7ODO8DB32D3E <br />ORANGE COUNTY —DEPARTMENT USE ONLY <br />Department <br />Party/Vendor Name: Scott Haigter.Electri , Party/Vendor Contact Person: Scott [jaigler Contact Phone: 919-479 - <br />9550 Party/Vendor Address: 6616 Blalock Road City Bahama State: NC Zip: 27503 Department: Asset <br />Maqqggj gnt Services Amount: 5 800 Purpose: obtain applicable mrinits and perform electrical work at ML(:O 3, <br />Justice Facilities, and SHSC Budget Code(s): 61370035-800000-30001 Vendor (N/A if new vendor) <br />Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New Renewal ❑ Amendment 0 <br />Effective Date 05/15/2015 Approved by Board Yes❑ Non Agenda Date: <br />This agreement is approved as to technical Porn , d&am;"t6y: <br />Department Director's Signature­ Date: 5/28/2015 <br />6UF644'99 <br />Information Technologies <br />(Applicable onb,, iw h4irdwarel,sojivva?-epiirchcise,5, 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 <br />Risk Mana2ement <br />Date: <br />This agreement is approved for sufficiency of insurance standards, specifications, and requirements: <br />DOGUSigned by: <br />Office of the Risk Management Officer_,,,,,,, .. 9US& (hnttft6 Date: 5/28/2015 <br />1!7FDCF9176800498... <br />Financial Services <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br />Act: DocuSigned by: <br />Office of the Chief Financial Officer Date; 5/28/2015 <br />Legal Services <br />ni is agreement is approved as to legal form a <br />Office of the County Attorney J6 Date: 5/29/2015 <br />Clerk to the Board <br />Received for record retentiow <br />All Docusign contracts must be copied to Donna lJoydupon completion )oL <br />IQ 0)Qr- )OV <br />yd� qr�& p qjq� <br />The following signature block is for hard copies only and is not required for Docusign contracts: <br />RevisQd 1084 <br />