HomeMy WebLinkAboutR 2019-063 AMS - Intellicom ES exterior wall data cable replacement DocuSign Envelope ID:A8A67740-1AF44E94-91311-523896817AB4
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Intellicom,Inc Party/Vendor Contact Person: Mike Bullock(mike@intellicomusa.com) Contact
Phone: 919-957-1949 Party/Vendor Address: 2902 S. Miami Blvd, Ste. C City Durham State: NC Zip: 27703 DS
Department: AMS/Emergency Services Amount: $2,207.00 Purpose: Remove the faceplates and jacks from the QI�
exterior walls of the building for reconstruction services Budget Code(s): 61370035 880000 10068 Vendor# 44533
(N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New ® Renewal
❑ Amendment ❑ Effective Date 2/6/19 Approved by Board Yes®No❑ Agenda Date: 2/5/19
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:
0 5'g a by:
Department Director's Signatur Vi"L iti5it's Date: 2/6/2019
Agreements for emergency services or repair are not subject 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: N/A
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:
oocuslg,,d by:
Office of the Chief Information Office �'"' 4 Date:2/6/2019
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Risk Management
This agreement is approved for sufficiency of insurance standards, specifications,and requirements:
0 5'g a by:
Office of the Risk Management Office ausa Emu ffo Date:2/6/2019
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Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
�115 o M a by:
Office of the Chief Financial Officer Z�;n CC14GP " Date:2/6/2019
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Legal Services
This agreement is approved as to legal form and sufficiency:
0 Mp.d by:
Office of the County Attorney[of a,�a to Date: 2/7/2019
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