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DocuSign Envelope ID:A8F1D92A-E386-4A03-943D-3319AC30E4B2 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Systel Business Equipment Party/Vendor Contact Person: Michelle Shepard Contact Phone: <br /> (336) 808-8000 Party/Vendor Address: P.O.Box 3591 City Fayetteville State: NC Zip: 28303 Department: <br /> Department of Social Services Amount: $4,392.00 Purpose: Copier for DSS Budget Code(s): 10400120-590000 <br /> Vendor# 11999 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) <br /> New® Renewal ❑ Amendment ❑ Effective Date 2February2021 Approved by Board Yes❑No® Agenda <br /> 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 executio �q"ment: <br /> Department Director's Signature I N" (166 u Date: 2/2/2021 <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: N/A <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 QQ* <br /> , [VK N6 2/2/2021 <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of ins ur a&ta%dards,specifications,and requirements: <br /> Q,,,, C,Vl�t , <br /> Office of the Risk Management Officer Date: 2/3/2021 <br /> FBEF9+78800498._. <br /> Financial Services <br /> This instrument has been pre-audited in the manner r iy,0idWy�:Local Government Budget and Fiscal Control Act: <br /> 4 ,� G/4 <br /> Office of the Chief Financial Officer Date: 2/3/2021 <br /> oIFS <br /> Legal Services <br /> This agreement is approved as to legal form and suffi Or..Sigued by: <br /> Office of the County Attorney J � F Date: 2/3/2021 <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 4 <br />