R 2015-591-E Health - Elizabeth Snyder-Fickler for consulting services for FSA

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DocuSign Envelope ID:48749442-9012-42A2-8713-E68E9941E952 ORANGE COUNTY—DEPARTMENT USE ONLY Deuartment Party/Vendor Name: Elizabeth Snyder-Fickler Party/Vendor Contact Person: Elizabeth Snyder-Fickler Contact Phone: 919-668-3288 Party/Vendor Address: 103 Ashley Brook Ct. 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 63479 (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 as to to c° T"W hy, id c ntent: t vVi 11/10/2015 Department Director's Signature �aG�onn�c.GSSas 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 riaixv„standards,specifications,and requirements: Q�ASA r,6vvte tt0 11/10/2015 Office of the Risk Management Officer � aeaa Date: Financial Services This instrument has been pre-audited i D9 iA%e t Wquired by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer Li Date: 11/10/2015 ear Legal Services This agreement is approved as to Ofb?W .sufficiency: Office of the County Attorney 4k 1 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