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DocuSign Envelope ID:73DB8DA0-A9A0-499E-BB4F-2118242D07A8 <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 <br /> Department: AMS/Emergency Services Amount: $2,200.00 Purpose: Install data at Churton Grove leased space for �(] <br /> Emergency Services to perform daily perations Budget Code(s): 61370035 880000 10068 Vendor#44533 (N/A if <br /> new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ <br /> Amendment ❑ Effective Date 2/20/19 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 /> Department Director's Signatur "" ��t ''is Date: 2/20/2019 <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 /> Office of the Chief Information Officer[ -,,� WLVW Date:2/20/2019 <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards, specifications,and requirements: <br /> Office of the Risk Management Office 1t 5"'bn1t f° Date:2/20/2019 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> PL <br /> Office of the Chief Financial Officer Date:2/22/2019 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Office of the County Attorney �' ` ° Date: 2/22/2019 <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 />