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DocuSign Envelope ID:611E22C1-26EE-4497-8BE6-60ABBB8AB5DF <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Intellicom, Inc. Party/Vendor Contact Person: Mike Bullock Contact Phone: 919-614-8110 <br /> Party/Vendor Address:2902 S. Miami Blvd Suite C City Durham State:NC Zip: 27703 Department: AMS Amount: <br /> $500 Purpose: Cabeling of Trailer Budget Code(s): 61370035-880000-10068 Vendor#44533 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ❑ Renewal ❑ Amendment ❑ <br /> Effective Date 3/25/2019 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 /> �W, PbV*aaA. 3/25/2019 <br /> Department Director's Signatur Date: <br /> 27 EF373ACD454EF.. <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: <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 sufficienc-- -riiocusgned-ay:` -'ds,specifications,and requirements: <br /> Office of the Risk Management Officer aCisa 'r'"h�aDate:3/25/2019 <br /> 7FOCF9176800498. <br /> Financial Services <br /> This instrument has been pre-audited: I7ocusigned by: i the Local Government Budget and Fiscal Control Act: <br /> .6 � 3/25/2019 <br /> Office of the Chief Financial Office 1ACC14 Date: <br /> 7D4E598d9. <br /> Legal Services Services <br /> This agreement is approved as ' ' DocuSigned by: ' fficiency: <br /> Office of the County AttorneCEAA3D3aED8AW5--6� K6k'l5 Date: 3/25/2019 <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 />