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DocuSign Envelope ID:90D6989A-A8CC-4862-9E6F-512DDOEAAF6E <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Intellicom, Inc Party/Vendor Contact Person: Mike Bullock Contact Phone: 919-957-1949 <br /> Party/Vendor Address: 2902 S Miami Blvd Ste C City Durham State: NC Zip: 27703 Department: AMS Amount: <br /> 3 153.00 Purpose: 405 Internal Cabling Budget Code(s): 61370035-880000-10069 Vendor # 44533 (N/A if new <br /> vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ❑ <br /> Amendment ❑ Effective Date 01/13/2020 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 Fsip• kmh Date:12/19/2019 <br /> s7"uBa81844C5. <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 content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurar-- -66c-„s;9ppneQ-by: - 6-`�-.ations,and requirements: <br /> Office of the 1Risk Management Officer Usa L Date: 12/19/2019 <br /> 7FDCF9176800498. <br /> Financial Services <br /> This instrument has been pre-audited in the man Docusigned by: Government Budget and Fiscal Control Act: <br /> 0 12/19/2019 <br /> Office of the Chief Financial Officer 7D4E5181ACC1409. Dat(. - <br /> Legal Services <br /> This agreement is approved as to legal form a DocuSigned by: <br /> , 66A, K6�C '6 12/19/2019 <br /> Office of the County Attorney EAA3D3sED8AW5.. 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 11/19 4 <br />