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DocuSign Envelope ID:OAE3C3F6-171 B-4145-8E97-BEB7A71 D5030 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Nelson Alarms, Inc. Party/Vendor Contact Person: Leigh Anne Nelson <br /> �N (lanelson67 @yahoo.com) Contact Phone: 336.685.0949 Party/Vendor Address: PO Box 10 City Randleman <br /> State: NC Zip: 27317 Department: AMS Amount: $4,718.18 Purpose: Installation of Fire Alarm System at the <br /> Efland-Cheeks Community Center Budget Code(s): 61370035-880000-30001 Vendor # 39886 (N/A if new <br /> vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ® Renewal ❑ <br /> Amendment ❑ Effective Date November 6,2017 Approved by Board Yes' No Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> Department Director's Signature[q °'">"°" Date: 11/2/2017 <br /> �etd �<o,�e<�n <br /> Asset Management <br /> (Applicable only to construction contracts)This agreement has been reviewed and is approved as to construction <br /> services content and specifications: <br /> osaed ev: <br /> Office of the Asset Management Director 2* °"1"°w Date: 11/2/2017 <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> Office of the Risk Management Office atria C"- Date: 11/9/2012 <br /> 7F.F9176800498 <br /> Financial Services <br /> rThis instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> vy Act: <br /> Office of the Chief Financial Officer C Date: 11/10/2017 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Office of the County AttorneyU6 G,w r s Date:11/10/2017 <br /> l°e EAA3o33EOeAa465_ <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 /> Revised 2/17 6 <br />