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DocuSign Envelope ID:3BC29991-ADE7-4DO3-8BB2-OF5968C8146D <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Intellicom, Inc. Party/Vendor Contact Person: Mike Bullock Contact Phone: 919-614-8110 <br /> Party/Vendor Address: 2029 S. Miami Blvd Suite C City Durham State:NC Zip: 27703 Department: AMS Amount: <br /> $1,313.00 Purpose: Run network cables for Millhouse Rd. Budget Code(s): 10240320-630000 Vendor#44533 (N/A <br /> if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ <br /> Amendment ❑ Effective Date 1/1/2019 Approved by Board Yes❑No® Agenda Date: <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work on <br /> this project has not been initiated prior to execution of the agreement: <br /> DocuSigned by: <br /> Department Director's Signatur11:�IIF1111111 <br /> �' Oft),4i9tlL Date:1/21/2019 <br /> EF.Agreements for emergency service,. ,N-.. ....,..F.�_oject 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 was <br /> addressed: This work was related to the relocation of staff from the Millhouse Rd Parks operation base to the temporary <br /> mobile unit on the same property due,based on a decesion by the Risk Manager. <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 sufficiencv of insurance standards,specifications,and requirements: <br /> DocuSigned by: ��tt <br /> Office of the Risk Management Offic �US& CbVh&6 Date:1/22/2019 <br /> 7FDCF9176900498. <br /> Financial Services <br /> This instrument has been pre-audited ^+DocuSigned by:e ""�"'y the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Office l 1.t�j Date: 1/23/2019 <br /> 7NE5181ACC1409. <br /> Legal Services <br /> This agreement is approved as to 1-11 fnrm a 1 c„fficiency: <br /> DocuSigned by: <br /> Office of the County AttorneC-3�� Pk'l5 Datc: 1/24/2019 <br /> EAA3D33ED8AW5.. <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 12/18 4 <br />