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DocuSign Envelope ID:A3DOFC59-07OD-48DB-AC4E-405DD26F2774 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: North State Communications Advanced Services, LLC Party/Vendor Contact Person: <br /> Andrew Stevenson Contact Phone: 336-821-8801 Party/Vendor Address: One Lumos Plaza City Waynesboro <br /> State: VA Zip: 22980 Department: AMS Amount: _ Purpose: Equipment Placement and Maintenance License <br /> Agreement Budget Code(s):_ Vendor#67739 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No <br /> ❑ Contract Type: (Check one)New ❑ Renewal ❑ Amendment ❑ Effective Date Approved by Board <br /> Yes❑No❑ Agenda Date: ---For Section XIV. c. contracts only, Approved by Board in Current FY Budget <br /> 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[.®%jai qby-tion of the agreement: <br /> Department Director's Signaturelwt 9MA Date: 2/6/2023 <br /> Agreements for emergency services or repair are noissubject 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 hardwarelsofm,are 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 Govermnent Budget and Fiscal Control <br /> Act: DocuSigned by: <br /> ,��,�,�/�,� 2/10/2023 <br /> Office of the Chief Financial Office , O Date: <br /> 1ACC1409... <br /> Legal Services <br /> This agreement is approved as t ^a143iva a%l sufficiency: <br /> Office of the County Attorney �bst fL hmv, Date: 2/10/2023 <br /> D <br /> Cleric to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to the Cleric 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 />