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DocuSign Envelope ID:AEA6A194-0163-467A-BO87-BOAB73895C5B <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Avis Barnes Party/Vendor Contact Person: Avis Barnes Contact Phone: (919) 883-6624 <br /> Party/Vendor Address: 3113 Genlee Dr. City Durham State: NC Zip: 27704 Department: Health Amount: $500 <br /> Purpose: TRU Advisor Budget Code(s): 10412020-630000-71454 Vendor# 52313 (N/A if new vendor) Vendor is <br /> a BOCC consultant? Yes ❑ No[] Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective <br /> Date July 1,2016 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to to m `f'b'@1AdMd content: <br /> �— a—a) 6/23/2016 <br /> Department Director's Signature Date: <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 sufficiency / SA, (hVV ct6 kt�jja;� ,,�tandards, specifications,and requirements: <br /> Office of the Risk Management Officer QU� Date: 6/24/2016 <br /> Financial Services <br /> This instrument has been pre-audited i t e_9MWiftF??6quired by the Local Government Budget and Fiscal Control Act: <br /> ta <br /> Office of the Chief Financial Officer Li 7D4E5181ACC1409... Date: 6/27/2016 <br /> Legal Services <br /> This agreement is approved as t egRF ffdal�l sufficiency: <br /> 6/27/2016 <br /> Office of the County Attorney a�,��,RR��a�,oaoa Date: <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 6/16 4 <br />