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DocuSign Envelope ID:4E53090E-A748-43C6-844B-8DDCC37F7E28 <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: 439.25 <br /> Purpose: Southern Human Services Generator repair-added Oil Budget Code(s): 10240320-570000 Vendor # 57533 <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one)New ❑ Renewal <br /> ❑ Amendment ❑ Effective Date 9/26/2019 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 12DD9CD6B81844C5_ <br /> im• 9MA Date: 10/28/2019 <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 for Southern Human Services was out of service due to low fluids.Expedited to have generator in <br /> service. <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 insu DocuSigned by: ifications,and requirements: <br /> [USA, L,QVIn�,{�b 10/28/2019 <br /> Office of the Risk Management Officer 7FDCF9176800498. Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner DocuSigned by: �vemment Budget and Fiscal Control Act: <br /> 10/28/2019 <br /> Office of the Chief Financial Officer 7D4E5,a,acc,aos. Date: <br /> Legal Services <br /> This agreement is approved as to legal form an [DocuSigned by: <br /> Office of the County Attorney 6� K6 Date:10/28/2019 <br /> EAA3033E08A84S5.. <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 />