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ATTACHMENT 1, Additional Terms and Conditions. <br />Revised 07/20 <br />3 <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br /> <br />Party/Vendor Name: Law Enforcement Services, Inc Party/Vendor Contact Person: Ellen Cutler Contact Phone: <br />336-852-6902 Party/Vendor Address: 3409-A West Wendover Ave City Greensboro State: NC Zip: 27407 <br />Department: Emergency Services Amount: 4,500.00 Purpose: Online Personal History Questionnaire and Post <br />Offer Psychological Evaluations Budget Code(s): 10757520-630000(EMS) and 10755020-630000(Comm)Vendor # <br />56947 (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New <br />Renewal Amendment Effective Date 11/23/2020 Approved by Board Yes No Agenda Date: <br /> <br /> <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 /> <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: During emergent hiring for EMS and Comm, we did utilize the services and was not aware the <br />contract had expired. LESI continued to use the same terms until we could get a contract executed. <br /> <br />Information Technologies <br /> <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 /> <br />Office of the Chief Information Officer___________________________________ Date: ________ <br /> <br />Risk Management <br /> <br />This agreement is approved for sufficiency of insurance standards, specifications, and requirements: <br /> <br />Office of the Risk Management Officer___________________________________ Date: _________ <br /> <br />Financial Services <br /> <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br />Act: <br /> <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br /> <br />Legal Services <br /> <br />This agreement is approved as to legal form and sufficiency: <br /> <br />Office of the County Attorney __________________________________________Date: ________ <br /> <br /> <br />Clerk to the Board <br /> <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 /> <br />Office of the Clerk to the Board __________________________________________Date:_________ <br /> <br /> <br />DocuSign Envelope ID: CE11723F-4BB9-4722-9ABC-90069CC20D28 <br />12/23/2020 <br />12/23/2020 <br />12/30/2020 <br />12/30/2020