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DocuSign Envelope ID:552AC7A3-1BOC-4D85-823C-370394803F33 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Custom Controls Unlimited, Inc Party/Vendor Contact Person: Devin Carroll Contact Phone: <br /> 919-661-5556 Party/Vendor Address: 2600 Garner Station Blvd City Raleigh State:NC Zip: 27603 Department: OC <br /> Planning and Inspections Amount: $737.00 Purpose: Management of hosted SCADA system Budget Code(s): <br /> 10695020/720013 Vendor# 63654 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract <br /> Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date O1July2019 Approved by Board Yes❑ <br /> 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 /> Jtm � 9/16/2019 <br /> Department Director's Signature C11eA91E73Ae4DF.. 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: <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 conten`--DocuSig�a-ey`:' <br /> im 4� <br /> Office of1JJC11&N)1E7aA64DF__ <br /> the Chief Information Officer Date: 9/16/2019 <br /> Risk Management <br /> This agreement is approved for sufficiency of insurani 'oo,,usig,,ea_ b by: <br /> .�— itions,and requirements: <br /> Office of the Risk Management Officer USX Cb Date: 9/16/2019 <br /> 7FDCF917e800498. <br /> Financial Services <br /> This instrument has been pre-audited in the manner DocuSigned ay: - - )vemment Budget and Fiscal Control Act: <br /> ('� 0�� 9/17/2019 <br /> Office of the Chief Financial Officer Date: <br /> 7D4E5181 A=400. <br /> Legal Services <br /> This agreement is approved as to legal form and suff D-uSigned by: <br /> �:IGS bv�Office of the County Attorney i7 L Date: 9/17/2019 <br /> 3286C48U549A4F5.. <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 />