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<br />Revised 06/21 <br /> <br />10 <br /> <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br /> <br />Party/Vendor Name: Siemens Industry, Inc Party/Vendor Contact Person: Jackie Crawley (jackie.crawley@siemens.com) <br />Contact Phone: 884.280.8295 Party/Vendor Address: 215 Southport Drive, Suite 900 City Morrisville State: NC Zip: 27560 <br />Department: AMS Amount: $13,233.00 Purpose: OC Library - Replace condensor coil, and other items per proposal Budget <br />Code(s): 61370035-800000-30018 Vendor # 53325 (N/A if new vendor) Vendor is a BOCC consultant? Yes No <br />Contract Type: (Check one) New Renewal Amendment Effective Date 9/3/2021 Approved by Board Yes No <br />Agenda Date: --- For Section XIV. c. contracts only, Approved by Board in Current FY Budget Yes No <br /> <br />This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this <br />project has not been initiated prior to execution of the a greement: <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 agreement have <br />already begun or been completed please briefly describe the nature of the emergency condition that was addressed: N/A <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 /> <br />Financial Services <br /> <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br /> <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 /> <br />DocuSign Envelope ID: DC20C545-C699-46B4-AC5F-59F82117CC6D <br />9/11/2021 <br />9/12/2021 <br />9/13/2021 <br />9/13/2021