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ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name : State of North Carolina Party/Vendor Contact Person: Joanne Rowland Contact Phone : <br /> Party/Vendor Address : 110 East King Street City Hillsborough State : NC Zip : 27278 Department : AMS Amount: $ 1 <br /> Per Term Purposes- 110 East King St, Lease Agreement Budget Code (s) : Vendor # (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes ® No ❑ Contract Type : (Check one) New ® Renewal ❑ Amendment ❑ <br /> Effective Date Approved by Board Yes ® No ❑ Agenda Date : 06/ 15 /2021 <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work on <br /> this project has not been initiated prior to execution of the agreement : <br /> Department Director ' s Signature AACA 04A Date : 4 " 3o a <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 was <br /> addressed : <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services) This agreement has been reviewed and is j <br /> approved as to information technology content and specifications : <br /> Office of the Chief Information Officer Date : <br /> Risk Management <br /> j <br /> This agreement is approved for sufficiency of insurance standards , specifications , and requirements : <br /> Office of the Risk Management Officer Date : <br /> Financial Services <br /> ft, <br /> This instrument has been pre- audited in the ma is re fired y the Local Government Budget and iscal Control Act : <br /> Office of the Chief Financial Officer Date : <br /> LeLyal Services <br /> A: <br /> This agreement is approved as to legal form and suff y : <br /> Office of the County Attorney Date : <br /> IMP <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 hap4opies onl y and is not required for Docusign contracts <br /> Office of the Clerk to the Boar Date l <br /> Revised 07/20 4 <br />