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ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name : Excellance , Inc . Party/Vendor Contact Person . Tommy Pugh Contact Phone : 256 772 - <br /> 9321 Party/Vendor Address : 453 Lanier Road City Madison State : AL Zip 35758 Department : Emergency <br /> Services Amount : $ 861 , 960 . 69 Purpose : New Ambulances and Chassis Budget Code (s) : 61757535 - 802000 -30010 <br /> Vendor # 56564 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No ® Contract Type : (Check one) <br /> New ® Renewal ❑ Amendment ❑ Effective Date Approved by Board Yes ® No ❑ Agenda Date : <br /> 5/24/2022 - - - For Section XIV . c . contracts only, Approved by Board in Current FY Budget Yes [:] 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 execution of the agreement : <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 : <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 specifications : <br /> Office of the Chief Information Officer Date : <br /> Risk Management <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 /> This instrument has been pre- audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act . <br /> Office of the Chief Financial Officer Date : <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency : <br /> Office of the County Attorney 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 />