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DocuSign Envelope ID:0350132E-2CD1-4D6B-927A-04A9lA3892D1 <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 /> Emergency Services Amount: $8,472.00 Purpose: Copier#2 for Emergency Services Budget Code(s): 10750020 <br /> 581000 Vendor# 11999 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: <br /> (Check one)New® Renewal ❑ Amendment ❑ Effective Date 12November2020 Approved by Board Yes <br /> ❑No® 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 /> DocuS jt,� (,S igned by: <br /> RKA� <br /> Department Director's Signature Date:11/30/2020 <br /> Agreements for emergency services or repair are not J9ect 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: N/A <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 JJa''r►S: <br /> VIA��l wt VTU. <br /> Office of the Chief Information Officer Date: 11/30/2020 <br /> Risk Management <br /> This agreement is approved for sufficiency of insur 6&1&�pWWpecifications,and requirements: <br /> Pa. / / <br /> Office of the Risk Management Officer chYve Date:12 1 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 r Date: 12/3/2020 <br /> Legal Services <br /> This agreement is approved as to legal form €f ft� y-. <br /> akt,S bv�a,,, 12/3/2020 <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 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 />