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DocuSign Envelope ID: 7F8DFDB2-D81A-4AOF-AF96-9B69F601FC96 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Deuartment <br /> Party/Vendor Name: NC PUBLIC HEALTH FOUNDATION Party/Vendor Contact Person: CHUCK BRIDGER Contact <br /> Phone: (980) 522-1621 Party/Vendor Address: PO BOX 18763 City RALIEGH State: NC Zip: 27619 Department: <br /> HEALTH Amount: $0.00 Purpose: QUIT LINE AMENDMENT Budget Code(s): Vendor 4 56861 (N/A if new <br /> vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New ❑ Renewal ❑ Amendment <br /> Effective Date 5/1/14 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to to ei�r1d content: <br /> Department Director's Signatur Date: 8/4/2015 <br /> llt,t,la, �jVY <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is approved as to <br /> information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficienc nFBC-F9+7&&6 rge„standards,specifications,and requirements: <br /> sa, (hm,&b 8/4/2015 <br /> Office of the Risk Management Officer � Da te: <br /> Financial Services <br /> This instrument has been pre-audited i <br /> r%_a exrrequired by the Local Government Budget and Fiscal Control Act: <br /> , <br /> Office of the Chief Financial Officer oF, Date: 8/4/2015 <br /> Legal Services <br /> This agreement is approved as t �� fnd sufficiency: <br /> Office of the County Attorne Date: 8/5/2015 <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 July 2015 <br />