HomeMy WebLinkAboutR 2019-822 AMS Intellicom remediation data work for G12 ClosetRevised 12/18 5
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 Department: AMS Amount: $8856.00 Purpose: All data work associated with remediation for G12 IT
Closet Budget Code(s): 61370035-880000-10077 Vendor # 44533 (N/A if new vendor) Vendor is a BOCC
consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date
11/5/2019 Approved by Board Yes No Agenda Date: 10/15/2019
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:
Department Director’s Signature ________________________________________ Date: ________
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
Risk Management
This agreement is approved for sufficiency of insurance standards, specifications, and requirements:
Office of the Risk Management Officer ___________________________________ Date: _________
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act:
Office of the Chief Financial Officer ____________________________________ Date: _________
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney __________________________________________Date: ________
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:_________
DocuSign Envelope ID: 1E518343-2340-4E32-861F-970C50FD99F0