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Revised 07/20 <br />9 <br />Vendor is a BOCC consultant? Yes No <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <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 City Durham State: NC Zip: 27703 Department: AMS Amount: <br />$80318.76 Purpose: To Install AV at the 1HZ($&%XLOGLQJ Budget Code(s): 61370035-80011-10064 Vendor # <br />44533 (N/A if new vendor Contract Type <br />(Check one) New Renewal Amendment Effective Date Approved by Board Yes No <br />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 />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 />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 insurance standards, specifications, and requirements: <br />Office of the Risk Management Officer___________________________________ Date: _________ <br />Financial Services <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br />Act: <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br />Legal Services <br />This agreement is approved as to legal form and sufficiency: <br />Office of the County Attorney __________________________________________Date: ________ <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 />DocuSign Envelope ID: 5AB4A2D9-25F9-4CA7-A8A7-770C48464D66 <br />5/17/2021 <br />5/18/2021 <br />5/19/2021 <br />5/30/2021 <br />5/31/2021