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DocuSign Envelope ID: 72574FBA-38BB-482F-A711-18C4CFEC2EDF <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: WakeMed Health and Hospitals & Wake Medical Laboratory Consultants Party/Vendor <br /> Contact Person: Kerry L. Hughes Contact Phone: 248-763-8504 Party/Vendor Address: 3000 New Bern Avenue <br /> City Ralei h State: NC Zip: 27610 Department: Health Amount: $25,000 Purpose: Laboratory Testing Budget <br /> Code(s): 10414020-630000 Vendor # NIA (NIA if new vendor) Vendor is a BOCC consultant? Yes [:] No® <br /> Contract Type: (Check one) New ® Renewal [:] Amendment ❑ Effective Date 11112015 Approved by Board <br /> Yes❑ No❑ Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> DocuSigned by: <br /> Department Director's Si nature <br /> (AAA14V �� Date: <br /> 1/1/2015 <br /> p g <br /> C9EMDOFC6B545E... <br /> Information Technologies <br /> (Applicable only to hardwarelsoftware purchases or related services) This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency ofua u ga��y standards, specifications, and requirements. <br /> F USA, 6bVVdb . 1/2/2015 <br /> Office of the Risk Management Office Date. <br /> 7FDCF91 76800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: IDocuSigned by: <br /> 1/2/2015 <br /> Office of the Chief Financial Officer Date: <br /> ... <br /> Legal Services <br /> This agreement is approved as to a4.forpidyd sufficiency: <br /> 1/2/2015 <br /> Office of the County Y Attorne � Date: <br /> L4035CB8304CA4A9... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion , Do11gjd(c_i)orangecountync.go V <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> Office of the Clerk to the Board Date: <br /> Revised 10/14 <br /> 8 <br />