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DocuSign Envelope ID:87297174-8311-443E-8424-CD9AE774C78C <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Applied Drives Inc Party/Vendor Contact Person: Dennis Hayes Contact Phone: 704-573-2324 <br /> Party/Vendor Address: PO Box 690245 City Charlotte State: NC Zip: 28227 Department: AMS Amount: $1990 <br /> Purpose: emergency repair Library boiler pump Budget Code(s): 10240320-570000 Vendor # 64802 (N/A if new <br /> vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ® Renewal ❑ <br /> Amendment ❑ Effective Date 10/04/2017 Approved by Board Yes' No Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> DocuSigned by: <br /> 10/5/2017 <br /> Department Director's Signature ye# npooino Date: <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: 11LL <br /> Office of the Risk Management Officer aLlSa �,bvvt e ttb Date: 10/6/2017 <br /> 7FDCF9176800498... <br /> DS <br /> Financial Services �� <br /> This instrument has been pre-audited in the ma 7r4i14y the Local Government Budget and Fiscal Control Act: <br /> 6/47 00..a/6m.. 10/6/2017 <br /> Office of the Chief Financial Officer 7o-4ES18��CC14fls._. Date: <br /> Legal Services <br /> This agreement is approved as to legal form and suficiesuc <br /> ocu ig d by: <br /> l°b tt, fs 10/6/2017 <br /> Office of the County Attorney ,)ttuA, Date: <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(a)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 />