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DocuSign Envelope ID:82FA214D-F8D2-4F89-9551-89D21AOA870C <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Deuartment <br /> Party/Vendor Name: Walgreen Co. Party/Vendor Contact Person: Dana Petri Contact Phone: 919-942-8738 <br /> Party/Vendor Address: 1106 Environ WE City Chapel Hill State: NC Zip: 27517 Department: Health Amount: <br /> $600.00 Purpose: Group in Budget Code(s): 10414020-630000-71405 Vendor 4 62867 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ <br /> Effective Date 7/1/15 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to f ?to pp o ,t-t-la.If rand content: <br /> �, <br /> Department Director's Signature Date: 8/12/2015 <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 sufficient g9V9a' standards,specifications,and requirements: <br /> Q�ASA r,6vvte tt0 8/12/2015 <br /> Office of the Risk Management Office _EncF_cLtzaa0DAga Date: <br /> Financial Services <br /> This instrument has been pre-audited i �sl�>� gLuired by the Local Government Budget and Fiscal Control Act: <br /> �A.U�, 8/12/2015 <br /> Office of the Chief Financial Officer e� Date: <br /> Legal Services <br /> This agreement is approved as t eg��Aff'1aWd sufficiency: <br /> 1 8/12/2015 <br /> Office of the County Attorney a��s gA��, oaoa 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 />