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9 <br />Contract Type: (Check one) New <br />No <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br />Party/Vendor Name: Siemens Industry, Inc Party/Vendor Contact Person: Clay <br />Graham(clay.graham@siemens.com) Contact Phone: 919-469-5095 Party/Vendor Address: 215 Southport Drive, <br />Suite 900 City Morrisville State: NC Zip: 27560 Department: AMS Amount: $19,750.00 Purpose: To replace <br />Whitted Building Chiller coils Budget Code(s): 61370035-800000-30018 Vendor # 53325 (N/A if new vendor) <br />No Vendor is a BOCC consultant? Yes Renewal <br />Amendment Effective Date Agenda Date: Approved by Board Yes <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 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 />Revised 11/19 <br />DocuSign Envelope ID: 7DC2E311-1D5A-4E02-8859-7381F3CDB95C <br />6/18/2020 <br />6/18/2020 <br />6/19/2020 <br />6/19/2020