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HomeMy WebLinkAboutR 2017-157-E HR - Selerix Systems, Inc. for 2017 ACA Subscription Agreement DocuSign Envelope ID:97D49820-FEB8-4DCA-BA8C-7909CD9FA2F9 ORANGE COUNTY-DEPARTMENT USE ONLY Department Party/Vendor Name: Selerix Systems, Inc. Party/Vendor Contact Person: Michelle DeShong Contact Phone: 214- 856-4211 Party/Vendor Address: 2851 Craig Drive, Suite 300 City McKinney State: TX Zip: 75070 Department: Amount: $12,792.00 Purpose: 2017 ACA Subscription Agreement Budget Code(s): 10250020/630000 Vendor #63369 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ❑ Renewal® Amendment ❑ Effective Date 1/1/2017 Approved by Board Yes No Agenda Date: This agreement is approved as to tec •' alc1csrot l content: 5/10/2017 Department Director's Signature /1711A413 Date: lit(.Y&D2e FSU148h... Information Technologies (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer Date: Risk Management This agreement is approved for sufficienc Y3l PRV_'' tanndards, specifications, and requirements: ((USA. rbvvutl6 5/10/2017 Office of the Risk Management Officer 7FDCF9176800498... Date: Financial Services This instrument has been pre-audited i 2€14nequired by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer ��� Date: 5/10/2017 7D4E5181ACC1409... Legal Services This agreement is approved as t Il$4fi1 r Yd sufficiency: A. ov arlt. fibSG6 Office of the County Attorney Date: 5/10/2017 o7-9€4D525C0F4FC... Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd @orangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board Date: Revised 2/17 5