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DocuSign Envelope ID: E27BCFAF-D97D-4E90-B3D4-B33F96BBE4D6 <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 /> Department on Aging Amount: $5,976.00(over 48 months) Purpose: Copier for Aging Budget Code(s): <br /> 10430020-590000 Vendor# 11999 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract <br /> Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date 1 June 2022 Approved by Board Yes❑ <br /> No® Agenda Date: ---For Section XIV.c.contracts only,Approved by Board in Current FY Budget Yes El <br /> No❑ <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 e "01W:agreement: <br /> Department Director's Signature J Date: 6 1 2022 <br /> IFA <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: <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 hsbys: <br /> Office of the Chief Information Officer Date: 6/2/2022 <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance �� ig er a Ds� specifications,and requirements: <br /> Office of the Risk Management Officer PUS& C,bvvu,llb Date: 6/15/2022 <br /> 7FDCF9176800498... <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 fan Date: 6/15/2022 <br /> e�Esr�raee��0s <br /> Legal Services <br /> This agreement is approved as to legal form 2F: <br /> �rt�� 6/15/2022 <br /> Office of the County Attorney 2� 4808A�&4F 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 06/21 <br /> 9 <br />