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DocuSign Envelope ID:D7825EB6-90DA-4C6B-AE71-06C612257720 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Ann Gerhardt Party/Vendor Contact Person: Ann Gerhardt Contact Phone: 919-622-4152 <br /> Party/Vendor Address: 123 Braswell Rd. City Chapel Hill State: NC Zip: 27216 Department: Health Amount: $800 <br /> Purpose: 10 hours executive coaching Budget Code(s): 10412020-530100-71453 Vendor # 64485 (N/A if new <br /> vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ® Renewal ❑ <br /> Amendment ❑ Effective Date Approved by Board Yes No Agenda Date: <br /> This agreement is approved as to to y,74(' Ph`1 '�d content: <br /> Vat VUt 5/23/2017 <br /> Department Director's Signature czrnon�4nF... Date: <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 q»aaliusn standards,specifications,and requirements: <br /> lt.St C,.V'IkLffb 5/24/2017 <br /> Office of the Risk Management Office Date: <br /> #Bero,7saooaoo... <br /> Financial Services <br /> This instrument has been pre-audited irrtnegiitiNfteitquired by the Local Government Budget and Fiscal Control Act: <br /> A" '°'z 5/31/2017 <br /> Office of the Chief Financial Officer — E5M1i1ACC1nng... Date: <br /> Legal Services <br /> This agreement is approved as t e bL .f✓ L sufficiency: <br /> Office of the County Attorney �� Date: 5/31/2017 <br /> County y 079A4D525C0F4FB <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 5 <br />