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DocuSign Envelope ID:F37C9396-0BA8-4BCE-A313-6FEB3715CF18 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Crisis Focus,LLC Party/Vendor Contact Person: Donald Campbell Contact Phone: 336-420- <br /> 3115 Party/Vendor Address: 3125 Katheleen Ave #160 City Greensboro State: NC Zip: 27408 Department: <br /> Emergency Services Amount: $19,500 Purpose: AAR Water Shortage Incident Budget Code(s): 30750020- <br /> 629000-71049 Vendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract <br /> Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 5/10/2017 Approved by Board Yes' <br /> No Agenda Date: <br /> This agreement is approved as to tec .gagcyntja gpd content: <br /> Department Director's Signature �1 ' LS Date: 5/8/2017 <br /> 5655BC891A64473... <br /> Information Technologies <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 o Dion ar cbeyatandards,specifications, and requirements: <br /> tats VLLtb 5/11/2017 <br /> Office of the Risk Management Office/ Date: <br /> `�—7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: , ---Docusigned by: <br /> Art 5/11/2017 <br /> Office of the Chief Financial Officer Date: <br /> 7D4E5181 ACC1409... <br /> Legal Services <br /> This agreement is approved as tq,legbticEand sufficiency: <br /> 5/11/2017 <br /> Office of the County Attorney 4i-1-444,- Date: <br /> `—4035C B 8304CA4A9... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecountync.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 2/17 <br /> 9 <br />