Orange County NC Website
ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br />Department <br />Party/Vendor Name: IproTechParty/Vendor Contact Person: Brad Reed Contact Phone: 704-301-8627Party/Vendor <br />Address: CityTempeState: AZZip: Department: County AttorneyAmount: Purpose: <br />Budget Code(s): 10315020 625000Vendor # N/A(N/A if new vendor) Vendor is a BOCC consultant? Yes Nox <br />Contract Type: (Check one) New Renewal Amendment Effective Date Approved by Board <br />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 />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 Sherri Ingersoll upon completion: singersoll@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 10/17(Mgr aprv 5k 6/18)4 <br />DocuSign Envelope ID: 91C2E157-827B-4CC8-BB64-1C9F43AD2D28 <br /> <br /> <br /> <br /> <br />