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DocuSign Envelope ID:02FC6ED9-8981-4956-885E-F423F641C1 ED <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Nelson Alarms,Inc Party/Vendor Contact Person: Leigh Anne Nelson Contact Phone: 336-685- <br /> 9049 Party/Vendor Address: PO Box 10 City Randleman State: NC Zip: 27317 Department: AMS Amount: <br /> $4,004.38 Purpose: Upgrade system at Cedar Grove Comm Ctr Budget Code(s): 10240320-630000 Vendor# 39886 <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New® Renewal <br /> ❑ Amendment ❑ Effective Date 10/05/2016 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> uSigned by: <br /> Doc <br /> Department Director's Signature ri Date:11/15/2016 <br /> 9E880A46CF64498... <br /> Information Technolosies <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 /> DocuSigned""by: <br /> ''1111 <br /> Office of the Risk Management Officer Fausa, rvu,�16 Date: 11/16/2016 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Officer Date: 11/16/2016 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form4AgVffi0'ency: <br /> r6u� s <br /> Office of the County Attorney 56Z, Date: 11/16/2016 <br /> EAA3D33ED8A8465... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloy(d c�orangecount.nic.Rov <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 6/16 5 <br />