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DocuSign Envelope ID: 1137F6E0-DEB3-49DB-96A7-532CBC37EDAE <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Keenan A. Williams, Electrical Contractor Party/Vendor Contact Person: Keenan A. Williams <br /> Contact Phone: 919-614-0203 Party/Vendor Address: 730 Eagle Point Road City Pittsboro State: NC Zip: 27312- <br /> 6176 Department: IT Amount: $1257.00 Purpose: Electrical upfit for Office of District Attorney IT closet Budget <br /> Code(s): 61370035/897140/30007 Vendor#65426 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑ No <br /> ® Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 01/25/2019 Approved by <br /> 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 /> Dim DocuSigne "`I"d/bye:,,,,Department Director's Signature W( Date:1/24/2019 <br /> Agreements for emergency services or repa WWWIW -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: <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 ands i l, U,,, ,,bgg4w§bY: <br /> �, I <br /> Office of the Chief Information Officer Date: 1/24/2019 <br /> „aa-e,Erg-a�-ao <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards. <br /> specifications,and requirements: <br /> [&& C,bvv b 2/7/2019 <br /> Office of the Risk Management Officer Date: <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> DocuSigned y: <br /> Office of the Chief Financial Officer +� Date: 2/7/2019 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency <br /> 5;GS uSig ed by: <br /> Office of the County Attorney Date: 2/7/2019 <br /> 328DC480549MF5... <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 />