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DocuSign Envelope ID:25158025-ADOF-4044-B3BF-3AB3BFDF53FD <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: NC State University — Sponsored Programs Party/Vendor Contact Person: Anne Leskv <br /> Contact Phone: 919-515-2444;anne leskykncsu.edu Party/Vendor Address:2701 Sullivan Drive,Admin. Services <br /> III Bldg., Suite 240, Campus Box 7514 (Send invoices to: Heather Brutz, NC State University, NC Clean Energy <br /> Technology Center, Campus Box 7409, Raleigh, NC 27695) City Raleigh State: NC Zip: 27695 Department: <br /> Asset Management Services Amount: Grant Reimbursement to County - $12,668 Purpose: Offset purchase price <br /> for electric motorcycle. Budget Code(s): 10710030-802000 Vendor# 1787 (N/A if new vendor) Vendor is a <br /> BOCC consultant? Yes ❑No® Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective <br /> Date November 1,2018 Approved by Board Yes®No❑ Agenda Date:November 13,2018 <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work <br /> on this project has not been initiated prior to execution of the agreement: <br /> DocuSigned by: <br /> Department Director's Signature �� Off),40L Date: 1/11/2019 <br /> Agreements for emergency services o, ,.,Fall 3ai�11vt auvj,a:t to the above affirmation. If services related to this <br /> agreement have already begun or been completed please briefly describe the nature of the emergency condition that <br /> was addressed: <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 /> DocuSigned <br /> _by: <br /> '�t <br /> Office of the Risk Management Officer aUS66 �,bvwc,li6 Date: 1/14/2019 <br /> 7FDCF91769004M- <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: <br /> Docusigned by: <br /> Office of the Chief Financial Officer 4 � Date: 1/14/2019 <br /> 704E51S1Ar-C1400- <br /> Le2al Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorney CEAAM3aED8A905__ <br /> 6� K6�tv15 Date: 1/15/2019 <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 /> Revised 12/18 <br />