Orange County NC Website
Browse       Search
ORANGE COUNTY—DEPARTMENT USE ONLY <br /> <br /> <br />Party/Vendor Name:Ticcon Party/Vendor Contact Person:Mark OnealContact Phone:919-493-0395Party/Vendor <br />Address:1901 Hillandale Dr <br /> CityDurhamState: NC Zip:27705 Department:AMS Amount: Purpose:Estoppel Budget <br />Code(s): Vendor # (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract <br />Type: (Check one) New Renewal Amendment Effective Date 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 <br />on this project has not been initiated prior to execution of the agreement: <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 <br />agreement have already begun or been completed please briefly describe the nature of the emergency condition that <br />was addressed: <br /> <br />Information Technologies <br /> <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 /> <br />Office of the Chief Information Officer Date: <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 />Financial Services <br /> <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br />Act: <br /> <br />Office of the Chief Financial Officer Date: <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 />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 /> <br /> <br /> <br /> <br /> <br />Revised 06/21 <br />9 <br />DocuSign Envelope ID: 156529D8-5B16-446B-831D-25832667FE0A <br />7/21/2022 <br />7/21/2022 <br />7/22/2022 <br />7/22/2022