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Revised 10/17 (Mgr apprv 5k 6/18) 4 <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br />Department <br />Party/Vendor Name: Intellicom , Inc. Party/Vendor Contact Person: Mike Bullock Contact Phone: 919-614-8110 <br />Party/Vendor Address: 2902 S. Miami Blvd. City Durham State: NC Zip: 27712 Department: AMS Amount: 522 <br />Purpose: Cabling Budget Code(s): Battle Courtroom project Vendor # 44533 (N/A if new vendor) Vendor is a <br />BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date <br />11/20/2018 Approved by Board Yes No Agenda Date: <br />This agreement is approved as to technical form and content: <br /> <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 />DocuSign Envelope ID: 5CC79CF7-8193-4C7B-9496-B0EA2656767C <br /> <br /> <br /> <br />