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DocuSign Envelope ID: EFOF4850-10E3-41OF-98DB-CFFA02CD2335 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Keenan A. Williams Party/Vendor Contact Person: Keenan Willams Contact Phone: 919-614- <br /> 0203 Party/Vendor Address: 730 Eagle Point Road City Pittsboro State: NC Zip: 27312 Department: Tax <br /> Administration Amount: 795 Purpose: Electrical and Mounting Projector Screen Budget Code(s): 10331020-630000 <br /> Vendor# 65426 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) <br /> New ® Renewal ❑ Amendment ❑ Effective Date 9/24/19 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 /> Department Director's Signat NIn C wiAVt. Date 9/25/2019 <br /> Agreements for emergency sere 118992D18s224sa.. ect 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 insurance standards,specifications,and requirements: <br /> DocuSigned by: <br /> Office of the Risk Management Offs aUSA 10/8/2019 <br /> �,4Wt.t,{�6 Datc: <br /> 7FDCF9176800498. <br /> Financial Services <br /> This instrument has been pre-audited in the manner rennired by the Local Government Budget and Fiscal Control Act: <br /> DocuSigned by: <br /> Office of the Chief Financial OM 41.&1. Date:10/8/2019 <br /> 704E5981ACC1409. <br /> Legal Services <br /> This agreement is approved as to leeal form and sufficiency: <br /> DocuSigned by, <br /> 10/8/2019 <br /> Office of the County AttorC_4035CB8304CA4M <br /> �,, fey, Date: <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 />