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DocuSign Envelope ID:4D816026-9372-4157-AD4B-30415072A9A4 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: National Power Party/Vendor Contact Person: Brent Horton Contact Phone: 919-790-1672 <br /> Party/Vendor Address: 4541 Preslyn Dr City Raleigh State: NC Zip: 27616 Department: AMS Amount: $849.13 <br /> Purpose: EMS Generator Services Budget Code(s): 10240320-570000 Vendor # 57533 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ❑ Amendment ❑ <br /> Effective Date 7/1/2019 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 /> ��' P6V*aln. 7/31/2019 <br /> Department Director's Signature 21EFMACD454EF.. Date. <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: Generator showing code.Would not start in case of emergency. <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 insura--- iSocus gnea by: rications,and requirements: <br /> a <br /> Office of the Risk Management Officer USA c6n �b Date: 8/6/2019 <br /> 7FQC F91 7E 800498. <br /> Financial Services <br /> This instrument has been pre-audited in the manner oocusigned by: wernment Budget and Fiscal Control Act: <br /> 1) 4 � 8/6/2019 <br /> Office of the Chief Financial Officer ` oa s,a=4as. Date: <br /> Legal Services <br /> This agreement is approved as to legal form a DocuSigned by: <br /> Office of the County Attorney �66A, K6k'6 Date: 8/9/2019 <br /> EAA3MaED&AW&- <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 />