Orange County NC Website
DocuSign Envelope ID: DA583654-9F26-4D03-8996-80949B3474CA <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Intellicom, Inc Party/Vendor Contact Person: Mike Bullock Mike@intellicomusa.com <br /> Contact Phone: 919.957.1949 Party/Vendor Address: 2902 S. Miami Blvd., Ste C City Durliam State: NC Zip: <br /> 27703 Department: AMS Amount: 1627.00 Purpose: Install cables in Whitted Room 210 Budget Code(s): <br /> 10240320-570001 Vendor#44533 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract <br /> Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date Approved by Board Yes❑No <br /> ® Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> r <br /> Department Director's Signature p"°" Date: 4/21/2016 <br /> oc <br /> Information Technologies <br /> (Applicable only to har•drvare/software purchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> ed <br /> Office of the Chief Information Officer 1 Date: 5/4/2016 <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> ly <br /> Office of the Risk Management Officer Q(asa Date: 5/5/2016 <br /> Co <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[E .A Date: 5/5/2016 <br /> Leal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> W <br /> w I Vs <br /> Office of the County Attorney��°lun uocuSgnetleo Date: 5/5/2016 <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydgoran ecoun•nc.gov <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> f <br /> Revised 1/16 5 <br />