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Revised 10/17 <br />8 <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ Department <br />Party/Vendor Name: Siemens Industry, Inc Party/Vendor Contact Person: Greg Collins Contact Phone: <br />919-465-5216 Party/Vendor Address: 215 Southport Dr St 900 City Morrisville State: NC Zip: 27597 <br />Department: AMS Amount: $1590.00 (FY 20-21 $44.16 FY 21-22 $530 FY 22-23 $530 FY 23-24 $$485.83 <br />Purpose: Northern Campus Fire Monitoring Service Agreement <br />Budget Code(s): 10240320-630000 Vendor # 53325 (N/A if new vendor) Vendor is a BOCC consultant? Yes No <br />Contract Type: (Check one) New Renewal Amendment Effective Date: Approved by Board: Yes No <br />Agenda Date: <br />Vendor is a BOCC consultant? Yes <br />This agreement is approved as to technical form and content: <br />Department Director’s Signature ________________________________________ Date: ________ <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 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 />DocuSign Envelope ID: BD2BDCCB-A936-4D6E-9287-E4BE0191A7FE <br />6/4/2021 <br />6/8/2021 <br />6/8/2021 <br />6/9/2021 <br />6/9/2021