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DocuSign Envelope ID:98857803-1FA0-48E8-8197-358680FE68E2 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: FESS Fire Protection Party/Vendor Contact Person: Ryan Willoughby Contact Phone: 919- <br /> 469-8099 Party/Vendor Address: 131 International Dr City Morrisville State: NC Zip: 27560 Department: AMS <br /> Amount: $1,452.13 Purpose: Annual Eyewash Inspections Budget Code(s): 10240320-630000 Vendor#60454 (N/A <br /> if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ❑ <br /> Amendment ❑ Effective Date 7/16/2019 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*aJA. <br /> Department Director's Signature Date: 7/17/2019 <br /> 21EF373AC0454EF.. <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 sufficiency of insr bocuSigned by:: _ ;ifications,and requirements: <br /> �Sa LQV'�t.f,{�b <br /> Office of1 the Risk Management Officer Date: 7/23/2019 <br /> 7FDCF9176800498. <br /> Financial Services <br /> This instrument has been pre-audited in the manner DocuSigned by: - —ovemment Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer 1 s�orx.w�ra. Date:7/2 3/2 019 <br /> 7NE5181ACC1400. — - <br /> Legal Services <br /> This agreement is approved as to legal form an' oocuSigned'6y: <br /> Office of the County Attorney �EAAM3aEMAW5- <br /> 6� K6k'6 Date: 7/2 5/2019 <br /> . <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 />