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DocuSign Envelope ID: 1 E1 F21 EB-78A5-441 C-A434-7983CB919C5D <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Intellicom Party/Vendor Contact Person: Mike Bullock Contact Phone: 919-957-1949 <br /> Party/Vendor Address: 2902 S Miami Blvd Suite C City Durham State: NC Zip: 27703 Department: AMS <br /> Amount: $8525.00 Purpose: To install Single Projection Image-6000 Lumen Budget Code(s): (20%) 10400130- <br /> 803000 $1705 (80%) 10240330-803000 $6820 Vendor # 44533 (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date <br /> 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 <br /> on this project has not been initiated prior to execution of the agreement: <br /> Docu��S��igned by: <br /> Department Director's Signat r�lLLW11 AMA Datel/8/2021 <br /> Agreements for emergency serve ?8f 'RIilffnot 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 /> 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 cont?t rodIgne gecifications: <br /> h y�,� <br /> Office of the Chief Information Offic r �t*m 4y��'""' "y Date: 1/8/2021 <br /> C11 BA91 E73A64DF... <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> DocuSigned`by, <br /> Q�Sa cbvvurtb 1/9/2021 <br /> Office of the Risk Management Off r Date: <br /> 7FDCF9176800498... <br /> Financial Services <br /> p DS <br /> r This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Offi Cer6�N_ Date: 1/12/2021 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to '11 suffcicncy: <br /> Office of the County Attorney ,�bS � Date: 1/12/2021 <br /> 4C5F3CDDF0B94F6... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@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 07/20 <br /> 9 <br />