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ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Naw Paw Paw Hser Party/Vendor Contact Person: Contact Phone: 919-904- <br /> 0735 Party/Vendor Address: 306 Estes Drive,Apt. C-12. City Carrboro State:NC Zip: 27710 Department: <br /> Health Amount: Purpose: Budget Code(s): Vendor#57963 (N/A if new vendor) Vendor is <br /> a BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New❑ Renewal ❑ Amendment ® Effective <br /> Date 10/17/2014 Approved by Board Yes❑Nor-1 Agenda Date: <br /> This agreement is approved as to technic l form and e <br /> Department Director's Signature Date: <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Director of Information Technology Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requiremen <br /> Office of Risk Management A.X-- i Date: *T 16 2014 <br /> 10116 <br /> Financial Services By <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: <br /> Office of the Chief Financial Officer /l A Date: 10 i l /y <br /> Lezal Services <br /> This agreement is approved as to legal form an s iency. <br /> Office of the County Attorney Date: l b <br /> Clerk to the Board <br /> Received for record retention: <br /> Office of the Clerk to the Board Date: <br />