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DocuSign Envelope ID:310FB506-AC14-4EA8-8183-981 FC2CD65C0 <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 /> Library Amount: $6,240.00 Purpose: Orange County Child Support Services Budget Code(s): 10440020-590000 <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 210ctober2020 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 /> DocuSigned by: <br /> F <br /> y:uc pxt".n.g4q, '"' 1012 212020 <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 ^ iAw <br /> Office of the Chief Information Officer Jt� Date: 10/22/2020 <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance shah-AWhopee�cifications,and requirements: <br /> Office of the Risk Management Officer QUSA, rbvv�.t lib Date:1012212020 <br /> 7FDCF9176800498... <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: 10/22/2020 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form an pie@W:by: <br /> �A Office of the County Attorney (IS f jr Date: 10/22/2020 <br /> Q�48QS4JF�4 <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 /> Revised 07/20 <br /> 9 <br />