HomeMy WebLinkAboutR 2019-036 AMS - Intellicom Millhouse cabling DocuSign Envelope ID:3BC29991-ADE7-4DO3-8BB2-OF5968C8146D
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: Intellicom, Inc. Party/Vendor Contact Person: Mike Bullock Contact Phone: 919-614-8110
Party/Vendor Address: 2029 S. Miami Blvd Suite C City Durham State:NC Zip: 27703 Department: AMS Amount:
$1,313.00 Purpose: Run network cables for Millhouse Rd. Budget Code(s): 10240320-630000 Vendor#44533 (N/A
if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑
Amendment ❑ Effective Date 1/1/2019 Approved by Board Yes❑No® Agenda Date:
This agreement is approved as to technical form and content and I as Department Director affirmatively state work on
this project has not been initiated prior to execution of the agreement:
DocuSigned by:
Department Director's Signatur11:�IIF1111111
�' Oft),4i9tlL Date:1/21/2019
EF.Agreements for emergency service,. ,N-.. ....,..F.�_oject to the above affirmation. If services related to this
agreement have already begun or been completed please briefly describe the nature of the emergency condition that was
addressed: This work was related to the relocation of staff from the Millhouse Rd Parks operation base to the temporary
mobile unit on the same property due,based on a decesion by the Risk Manager.
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 sufficiencv of insurance standards,specifications,and requirements:
DocuSigned by: ��tt
Office of the Risk Management Offic �US& CbVh&6 Date:1/22/2019
7FDCF9176900498.
Financial Services
This instrument has been pre-audited ^+DocuSigned by:e ""�"'y the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Office l 1.t�j Date: 1/23/2019
7NE5181ACC1409.
Legal Services
This agreement is approved as to 1-11 fnrm a 1 c„fficiency:
DocuSigned by:
Office of the County AttorneC-3�� Pk'l5 Datc: 1/24/2019
EAA3D33ED8AW5..
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@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 12/18 4