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DocuSign Envelope ID:80160778-AE5F-4DC7-AAC5-2C5C76CD400D <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Penta Engineering Group Inc Party/Vendor Contact Person: Dan Blair (dblair @pentaeng.com) <br /> Contact Phone: 919-455-0212 Party/Vendor Address: 4000 Miller Court West City Norcross State: GA Zip: 30071 <br /> Department: AMS Amount: $650.00 Purpose: Material Testing in Conference Rooms 009 & 011 for installation of <br /> back up 911 Call Center Budget Code(s): 61370035-870000-30062 Vendor#61470 (N/A if new vendor) Vendor is <br /> a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective <br /> Date 3/23/17 Approved by Board Yes No Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> Department Director's Signature Date: <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 /> DcSg dby' <br /> Q(asa(ewu,ffo 3/15/2017 <br /> Office of the Risk Management Office „„„,„,„,_ Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> D se dby <br /> Office of the Chief Financial Officer l'N `6-41— Date: 3/15/2017 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> l---DOCUSigned by: <br /> Muti,rek,r6 3/16/2017 <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 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 2/17 5 <br />