Orange County NC Website
Revised 11/19 <br />8 <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br /> <br />Party/Vendor Name: William H. Russ Party/Vendor Contact Person: Bill Russ Contact Phone: 919-949-2533 <br />Party/Vendor Address: 818 East Forest Hills Blvd City Durham State: NC Zip: 27707 Department: <br />Amount: $15,000.00 Purpose: videos Budget Code(s): 600000 Vendor # 63973 (N/A if new vendor) Vendor is <br />a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective <br />Date 1/17/20 Approved by Board Yes No Agenda Date: <br /> <br />This agreement is approved as to technical form and content and I as Department Director affirmatively state work <br />on this project has not been initiated prior to execution of the agreement: <br /> <br /> <br />Department Director’s Signature ________________________________________ 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 <br />was addressed: <br /> <br />Information Technologies <br /> <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 /> <br />Office of the Chief Information Officer___________________________________ Date: ________ <br /> <br />Risk Management <br /> <br />This agreement is approved for sufficiency of insurance standards, specifications, and requirements: <br /> <br />Office of the Risk Management Officer___________________________________ Date: _________ <br /> <br />Financial Services <br /> <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br />Act: <br /> <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br /> <br />Legal Services <br /> <br />This agreement is approved as to legal form and sufficiency: <br /> <br />Office of the County Attorney __________________________________________Date: ________ <br /> <br /> <br />Clerk to the Board <br /> <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 /> <br />Office of the Clerk to the Board __________________________________________Date:_________ <br /> <br /> <br /> <br /> <br />DocuSign Envelope ID: 5CC0B632-B38C-4C47-874F-5587F1FAE71F <br /> <br /> <br /> <br />