Orange County NC Website
DocuSign Envelope ID:0526F367-6FED-4512-B59A-6F46E8491317 <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:DSS <br /> Amount: $4,752.00 Purpose: Orange County Department of Social Services 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 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 /> D C656t&ocuSigned by: <br /> � <br /> Department Director's Signature N Date:9/2/2020 <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 asy: <br /> IWt 44v1 9/2/2020 <br /> Office of the Chief Information Officer � Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insuraa�Sa rbVttit,{T cMai Edkiy:' O slpl1ecifications,and requirements: <br /> Office of the Risk Management Officer Date: 9/2/2020 <br /> eErsi�saeoasa... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: ocuSigned by: <br /> Office of the Chief Financial Officer Fr�� 0atdllsosr. Date:9/2/2020 <br /> Legal Services <br /> This agreement is approved as to legal form and su igned by: <br /> awtt,S br�at& <br /> Office of the County Attorney Date:/2/2020 <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 />