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DocuSign Envelope ID: B75F4E71-4581-407F-B802-DB6355E16724 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Deuartment <br /> Party/Vendor Name: Shari Covenev Party/Vendor Contact Person: Shari Covenev Contact Phone: 919-280-6638 <br /> Party/Vendor Address: 1622 Worth St. City Hillsborough State: NC Zip: 27278 Department: Health Amount: $500 <br /> Purpose: TRU Advisor Budget Code(s): 10-4020-20-630000-71454 Vendor 4 62244 (N/A if new vendor) Vendor <br /> is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New ❑ Renewal ® Amendment ❑ Effective <br /> Date July 1,2015 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to to ((R aAWTAftd ontent: <br /> 6"�'t'�' ev 6/1/2015 <br /> Department Director's Signatura��s�s �E 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 Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficienc d&w6jwg„5tandards,specifications,and requirements: <br /> ausa, (hm,&6 6/1/2015 <br /> Office of the Risk Management Officer Date: <br /> PbCF�"1�6�9H0#9... <br /> Financial Services <br /> This instrument has been pre-audited ' @°gtf�p�required by the Local Government Budget and Fiscal Control Act: <br /> �A.U�, 6/2/2015 <br /> Office of the Chief Financial Office e� Date: <br /> Legal Services <br /> This agreement is approved as to ad"rjaiduW sufficiency: <br /> 6/3/2015 <br /> Office of the County Attorney Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloyLyorangecou 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 5 <br />