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DocuSign Envelope ID:A9E76943-AF44-4034-A933-05655779889A <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Siemens Industry, Inc Party/Vendor Contact Person: Greg Collins Contact Phone: 910-728- <br /> 7678 Party/Vendor Address: 215 Southport Dr Suite 900 City Morrisville State: NC Zip: 27560 Department: <br /> AMS Amount: $51,049.00 Purpose: Annual Siemens Services Budget Code(s): 10240320-630000 Vendor # <br /> 53325 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New ❑ <br /> Renewal ❑ 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 <br /> on this project has not been initiated prior to execution of the agreement: <br /> DocuSigned by: <br /> �W POI't+kNA' <br /> Department Director's Signature Date: 7/25/2019 <br /> 21EF373ACD454EF"" <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 <br /> was 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 Docusigned"ay:" ;cifications,and requirements: <br /> Q�ts�'Office of the Risk Management Officer 7FDCF9,76800498" Date: 7/29/2019 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: DocuSigned by: <br /> ( <br /> Office of the the Chief Financial Officer 7DaE5,s,Acc,aas" Date:8/1/2019 <br /> Legal Services <br /> This agreement is approved as to legal form DocuSigned by: <br /> Office of the County Attorney �66A, K6k�'6 EAA3D33ED&AW5"" Date.8/5/2019 <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 <br /> 8 <br />