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DocuSign Envelope ID:561AE95D-AC72-4264-B6FD-D416224A6CC5 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Departm en k <br /> ["arty/Vendor Name: Siemens Indust1y,Inc PartyNendor Contact Person: Brian Beebe Contact Phone: 919-468- <br /> 2324 Party/Vendor Address: 215 Southport Dr, Suite 900 City Morrisville State: NC Zip: 27560 Department: <br /> AMS Amount:$48,118 Purpose:Annual Service Agreement Budget Code(s): 10240320-630000 Vendor#53325 <br /> (N/A if new vendor) Vendor is a BDCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ <br /> Renewal ❑ Amendment ❑ Effective Date 11/01/2016 Approved by Board Yes❑ No❑ Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> CP9E88CA46CF64408 <br /> DocuSigned dy: <br /> Department Director's Signature `# � 'r",o Date: 11/15/2016 <br /> Information Technologies <br /> (Applicable only to hardwarelsoftwure 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 /> I <br /> I <br /> Risk Management <br /> I <br /> This agreement is approved for sufficiency Docusigned by: is,specifications,and requirements: <br /> Office of the Risk Management Officer Date: 11/16/2016 <br /> g 7F6CF9170800498.-. � --- <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the local Government Budget and Fiscal Control <br /> Act: DocuSigned by: <br /> Office of the Chief Financial Officer Date: 11/21/2016 <br /> Ir7NE5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to oocusigned by: iency: <br /> � <br /> A W Pk� 4S <br /> Office of the County Attorney 6 _Date: 11/21/2016 <br /> EAA3033EO8A84a"5-.- <br /> Cleric to the Board <br /> I <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloydupon completion Dolloyd(&_,oran eg couptvnc.gov <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> Revised 6/16 6 <br />