R 2015-590-E Health - Charla Nicole Lawrence to provide consulting services for FSA

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DocuSign Envelope ID: F909898A-9A64-47A3-92F3-329E60FE71BE ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Charla Nicole Lawrence Party/Vendor Contact Person: Nicole Lawrence Contact Phone: 919- 688-3282 Party/Vendor Address: 104 Cavendish Drive City C M State: NC Zip: 27513 Department: Health Amount: $3,000 Purpose: Consulting services for FSA Budget Code(s): 10412020-630000-71453 Vendor 4 63435 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 10/22/15 Approved by Board Yes❑No❑ Agenda Date: This agreement is approved a to to E�Y°ft%Y�,¢,,id ontent: t�- 1' 11/10/2015 Department Director's Signature cQFns�FCFRSas Date: Information Technologies (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer Date: Risk Management This agreement is approved for sufficienc dasarawaystandards,specifications,and requirements: aura, (hm,&b 11/10/2015 Office of the Risk Management Officer Fecfs��aooa�s_. Date: Financial Services This instrument has been pre-audited i Inquired by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer i� � � Date: 11/10/2015 e e fl.,aa ... Legal Services This agreement is approved as t tfbwiWhnd sufficiency: Office of the County Attorney Date: 11/10/2015 Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloyLyorangecou go v The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board Date: Revised 10/14 4