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Revised 10/17 <br /> <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br />Department <br />Party/Vendor Name: TMA Systems, LLC Party/Vendor Contact Person: Dustin Taylor (President) Contact Phone: 918-858-6683 Party/Vendor <br />Address: 5100 East Skelly Drive, Suite 900City TulsaState: OKZip: 74135Department: AMSAmount: $0.00Purpose: Switch out the modules. <br />Budget Code(s): CIP <br />61370035-897070-30007 / 10315020-625010Vendor # N/A(N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: <br />(Check one) New Renewal Amendment Effective Date March 27th, 2017Approved by Board Yes No Agenda Date: March 21st, <br />2017 <br />This agreement is approved as to technical form and content: <br />Department Director’s Signature ________________________________________ Date: ________ <br />Asset Management <br />(Applicable only to construction contracts) This agreement has been reviewed and is approved as to construction services content and specifications: <br />Office of the Asset Management Director__________________________________ Date: ________ <br />Risk Management <br />This agreement is approved for sufficiency of insurance standards, specifications, and requirements: <br />Office of the Risk Management Officer___________________________________ 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 />Office of the Chief Financial Officer ____________________________________ Date: _________ <br />Legal Services <br />This agreement is approved as to legal form and sufficiency: <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 />DocuSign Envelope ID: 6E571D53-1093-46BB-B803-EFCBF18D5450 <br /> <br /> <br /> <br />