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i <br /> Q <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name : Eno Fire Department Party/Vendor Contact Person : Chief Keith Ham Contact Phone : <br /> Party/Vendor Address : 5019 Old Hillsborough Rd . City Durham State : NC Zip $ 27705 Department : <br /> Orange Cognly Emergency Services Amount : Monthly payment waived for a period of eighteen months from <br /> effective date of this agreement — after that, $ 500 . 00 per month Purpose : Co - location Budget Code (s) : 10757520 - <br /> 630000 Vendor # (N/A if new vendor) Vendor is a BOCC consultant ? Yes ❑ No ❑ Contract Type : <br /> (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 01 /01 / 19 Approved by Board Yes ® No ❑ <br /> Agenda Date : 11 /02/2017 <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 /> Department Director ' s Signature L - Date : <br /> Agreements for emergency services or repair are not su ec It , 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/sofhvare 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 /> Financ ' 1 S vices <br /> This instrument has been pre - audited in the er r it d by the Local Government Budget and Fiscal Control <br /> Act : <br /> Office of the Chief Financial Officer �_ _ Date : Z Z <br /> Legal Services <br /> This agreement is approved as to legal fo d 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 12/ 18 <br />