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DocuSign Envelope ID:A8A67740-1AF44E94-91311-523896817AB4 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Intellicom,Inc Party/Vendor Contact Person: Mike Bullock(mike@intellicomusa.com) Contact <br /> Phone: 919-957-1949 Party/Vendor Address: 2902 S. Miami Blvd, Ste. C City Durham State: NC Zip: 27703 DS <br /> Department: AMS/Emergency Services Amount: $2,207.00 Purpose: Remove the faceplates and jacks from the QI� <br /> exterior walls of the building for reconstruction services Budget Code(s): 61370035 880000 10068 Vendor# 44533 <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New ® Renewal <br /> ❑ Amendment ❑ Effective Date 2/6/19 Approved by Board Yes®No❑ Agenda Date: 2/5/19 <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 /> 0 5'g a by: <br /> Department Director's Signatur Vi"L iti5it's Date: 2/6/2019 <br /> Agreements for emergency services or repair are not subject 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: N/A <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 /> oocuslg,,d by: <br /> Office of the Chief Information Office �'"' 4 Date:2/6/2019 <br /> C11 BA91E]3Ag60F. <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards, specifications,and requirements: <br /> 0 5'g a by: <br /> Office of the Risk Management Office ausa Emu ffo Date:2/6/2019 <br /> ]FUCEg,IggR�gg_. <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> �115 o M a by: <br /> Office of the Chief Financial Officer Z�;n CC14GP " Date:2/6/2019 <br /> �76dE5iE17�'C� <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> 0 Mp.d by: <br /> Office of the County Attorney[of a,�a to Date: 2/7/2019 <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 /> Office of the Clerk to the Board Date: <br /> Revised 12/18 4 <br />