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DocuSign Envelope ID:53D55D40-1809-4F65-BAC5-CBC288F3AD4B <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Catharine Rice Party/Vendor Contact Person: Catharine Rice Contact Phone: 919-740-0257 Party/Vendor <br /> Address: 424 East Alexandria Ave City Alexandria State:VA Zip: 22301 Department: IT Amount: $5,000.00 Purpose: Broadband <br /> Consulting for ARPA funds Budget Code(s): 61370035-897085-30007 Vendor# 67134 (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes ❑ NoX❑ Contract Type: (Check one)New❑ Renewal ❑ Amendment X❑ Effective Date 8November2021 <br /> Approved by Board Yes❑ NoX❑ Agenda Date: --- For Section XIV. c. contracts only, Approved by Board in Current FY <br /> Budget Yes❑No❑ <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has <br /> not been initiated prior to execution of the agreement: <br /> DocuSigned by: <br /> Department Director's Signature Nb 4ayDate:11/8/2021 <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: <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is approved as to <br /> information technology content and specifications: rDocuSignedby: <br /> y�� <br /> Office of the Chief Information Officer Date:11 8/2021 <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance bto�q9 rq%,speecifications,and requirements: <br /> Office of the Risk Management Officer Q�tSa r,O�6 Date: 11/8/2021 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the mann MquitEueb4opthe Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer (A� Date:11/8/2021 <br /> Legal Services <br /> This agreement is approved as to legal form and f 7"o by: <br /> haom,S brm& / <br /> Office of the County Attorney __._!J Date:11 8/2021 <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 06/21 <br />