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DocuSign Envelope ID:8E17FF51-CCE6-4936-84F0-05EABCB1E7FA <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: James Wise Party/Vendor Contact Person: James Wise Contact Phone: (919) 929-2106 x41270 <br /> Party/Vendor Address: 2324 Woodbury Drive City Hillsborough State:NC Zip: 27278 Department: Health Amount: <br /> 5500 Purpose: TRU Advisor Budget Code(s): 10412020-630000-71454 Vendor # 57567 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ <br /> Effective Date July 1,2016 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to to n `Y�'P1lSdAd c ntent: <br /> 8/16/2016 <br /> Department Director's Signature C9FO9ooFCSasasB_ 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 sufficient �nffiw�aorstandards, specifications,and requirements: <br /> !usa, r,6rin,c,�16 8/16/2016 <br /> Office of the Risk Management Officer ,PnrPai7sannAQ Date: <br /> Financial Services <br /> This instrument has been pre-audited i e'Iffl ftUdib�quired by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer � C?q Date: 8/16/2016 <br /> �pgB�R�ncr.�an4-- <br /> Legal Services <br /> This agreement is approved as t eg9FT8t4f M d sufficiency: <br /> Office of the County Attorney Date: 8/17/2016 <br /> �,1 3' 4035CB83D4CA4A9... <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 />