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DocuSign Envelope ID:8CE73FE5-1016-421D-BB52-BOB7C778D1C4 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Warren-Hay Party/Vendor Contact Person: Ron LaPann Contact Phone: 919-732-4362 <br /> Party/Vendor Address: PO Box 818 City Hillsborough State: NC Zip: 27278 Department: AMS Amount: $2542.00 <br /> Purpose: Gateway RTU-2/RTU-3 emergency call Budget Code(s): 10240320-570000 Vendor# 25352 (N/A if new <br /> vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ❑ <br /> Amendment ❑ Effective Date 9/11/2019 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 /> Department Director's Signature 9M Date.10/9/2019 <br /> sooscoaes�a44c5. <br /> Agreements for emergency services or repair are not sunject to the anove 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: This was an emergency call due to the Tax office and Vital records did not have HVAC for a length of time. <br /> The call was made after Maintenance had made several attempts to get the HVAC operational. The tax office was <br /> considering closing. <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 insur DocuSiggned by: :lcatlons,and requirements: <br /> 17FDCF917680OL98 <br /> usa. cbm_ �6 10/10/2019 <br /> Office of the Risk Management Officer . Date: <br /> Financial Services <br /> This instrument has been pre-audited in the mann(--=1��MCC1409 <br /> " un a`ay' T ' government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer Date: 10/10/2019 <br /> . <br /> Legal Services <br /> This agreement is approved as to legal form and oocusigned by: <br /> Office of the County Attorney �blLw �K6� Date: 10/10/2019 <br /> E1+AM33ED&AW5.. <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 />