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DocuSign Envelope ID: D7B014C7-E395-4724-BF7E-F6D1DDEBCED5 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Addbukola Oni Party/Vendor Contact Person: Addbukola Oni Contact Phone: 240-413-3405 <br /> Party/Vendor Address: 1726 Vista Street City Durham State: NC Zip: 27701 Department: Health Amount: $2.100 <br /> Purpose: Criminal Justice and Health Report Budget Code(s): 10412020-630000-71456 Vendor# 63528 (N/A if new <br /> vendor) Vendor is a BOCC consultant? Yes ❑ No[] Contract Type: (Check one) New ® Renewal ❑ <br /> Amendment ❑ Effective Date 1/15/16 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to to ualufwm and content: <br /> Department Director's Signature Date: 1/4/2016 <br /> Information Technolosies <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 uC� <br /> mctiystandards, specifications,and requirements: <br /> Qusa, (hVV't 6 1/4/2016 <br /> Office of the Risk Management Officer 4FOGF94W-9S90498 Date: <br /> Financial Services <br /> This instrument has been pre-audited i e114MMh'&P�quired by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer <br /> i t a sFSassar ±nQ Date: 1/4/2016 <br /> � <br /> Legal Services <br /> This agreement is approved as tqirgMcf@rmclATd sufficiency: <br /> Office of the County Attorney '�q'`� Date: 1/6/2016 <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloy(d c�orangecount.nic.gov <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 />