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DocuSign Envelope ID:5ED72C25-367F-4644-8955-DCB9E8B51453 <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 /> Health Amount: $6,600.00 Purpose: Orange County Health Hillsborough Budget Code(s): 10410020-590000 <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 27August2020 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 /> PZ4� <br /> Signed by: <br /> �'� <br /> Department Director's Signature Date: 8/28/2020 <br /> Agreements for emergency services or repair are not su sect 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 spr2G11BA91F=73A649F <br /> �i Wba by: <br /> KA Na 8/28/2020 <br /> Office of the Chief Information Office Date: <br /> : <br /> Risk Management <br /> This agreement is approved for sufficiency of ins ahwdar�is,specifications,and requirements: <br /> Office of the Risk Management Officer &A. rbvvulTO Date:8/28/2020 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: DocuSigned by: <br /> Office of the Chief Financial Officer Date:8/28/2020 <br /> Legal Services <br /> This agreement is approved as to legal form h €€€a00,S ew0y. <br /> ,� <br /> Office of the County Attorney Date:8/28/2020 <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 /> 9 <br />