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DocuSign Envelope ID: F638EDF1-1 C98-4839-8265-Fl 7C1 FB2CEBE <br /> DS <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Nelson Alarms,Inc Party/Vendor Contact Person: Leigh Anne Nelson Contact Phone: 336-685- <br /> 0949 Party/Vendor Address:PO Box 10 City Randleman State:NC Zip: 27317 Department: AMS Amount: $671.88 <br /> Purpose: add security s ste Budget Code(s): 61370035 880000 10068 Vendor # 39886 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ <br /> Effective Date 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 Signature 'Lila, pb�� Date 2/20/2019 <br /> Agreements for emergency services or re 21 E 3ACD454EF-- 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 and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of ins»rnnoP ctnndnrrlc -nPcifications,and requirements: <br /> DocuSigned by: <br /> �US& �,DV1n.��b <br /> Office of the Risk Management Officer Date: 2/20/2019 <br /> 7FDC F91 76800498- Ir <br /> 0.S <br /> Financial Services � <br /> This instrument has been pre-audited in the ma,-"-- 66-cuSigned ay: `'"" T ""-i1 Government Budget and Fiscal Control Act: <br /> 2/22/2019 <br /> Office of the Chief Financial Officer lt� 4 " Date: <br /> 7D4E5181Ar-C1400- <br /> Le2al Services <br /> This agreement is approved as to legal form and sufficiencv: <br /> DocuSigned by: <br /> Office of the County Attorney �b� K6�u'l5 Date: 2/22/2019 <br /> EAA3MaEDSAW&- <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 />