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DocuSign Envelope ID:86005D5D-54F4-4685-9411-26EDF6150D39 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Intellicom, Inc Party/Vendor Contact Person: Mike Bullock Contact Phone: 919-957-1949 <br /> Party/Vendor Address: 2902 S. Miami Blvd, Ste. C City Durham State: NC Zip: 27703 Department: IT Amount: <br /> 3 600.00 Purpose: Provide service work for low voltage cabling for 80 labor hours in Orange County Governmental <br /> facilities Budget Code(s): 10315020/571000 Vendor#44533 (N/A if new vendor) Vendor is a BOCC consultant? <br /> Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date March 1, 2019 <br /> 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 /> P <br /> D M t4vg vI ocuSigned by: <br /> Department Director's Signature Date: 3/4/2019 <br /> Agreements for emergency services or repair are not subject to fhe 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 PA§�; <br /> �IIM l <br /> Office of the Chief Information Officer UbVfu Vl Date: 3/4/2019 <br /> z�te-rsaea ... <br /> Risk Management <br /> This agreement is approved for sufficiency of ins E <br /> &a*Wards,specifications,and requirements: <br /> iSa <br /> Vvullb 3 <br /> Office of the Risk Management Officer Date: /4/2019 <br /> Financial Services <br /> This instrument has been pre-audited in the manner didnrtl a Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer �a 0 Date: 3/4/2019 <br /> Legal Services <br /> This agreement is approved as to legal form an h Deus :by: <br /> Office of the County Attorney `t �s Date:3/4/2019 <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 />