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DocuSign Envelope ID:AO5BAC11-3B82-4B08-8F14-C38030E0460A <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: ProNet Systems, Inc. Party/Vendor Contact Person: Alan Jelley Contact Phone: 919-277-2070 <br /> Party/Vendor Address: 3200 Glenn Royal Rd Suite 107 City Raleigh State: NC Zip: 27617 Depallnient: AMS <br /> Amount: $3,668.09 Purpose: Add two card readers Budget Code(s): 61370035-880000-30001 Vendor# 57979 (N/A <br /> if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ® Renewal ❑ <br /> Amendment ❑ Effective Date 12/12/2016 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> DocuSigned by: <br /> Department Director's Signature P.# �O"`7"�°"' Date: 1/18/2017 <br /> °"----9E880A46CF64498... <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 /> DocuSigned""by: <br /> '' <br /> Office of the Risk Management Officer ((USX COrvu t111i1 <br /> 4 Date: 1/18/2017 <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 /> DocuSign by: <br /> Office of the Chief Financial Officer (21.4-N An Date: 1/21/2017 <br /> `---7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and slfficcibency: <br /> p IIocu igney:�,,L, <br /> Office of the County Attorney <br /> jaLtA, leOtitx s Date: 1/23/2017 <br /> '----EAA3D33ED8A8465... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@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 6/16 5 <br />