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DocuSign Envelope ID:638103E7-1811-4F77-A8B6-C4EA6785E654 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Claudia H. Sheppard,DVM,MS Party/Vendor Contact Person: Claudia H. Sheppard,DVM,MS <br /> Contact Phone: 919-933-0713 PartyNendor Address: 101 Autumn Lane City Chapel Hill State: NC Zip: 27516 <br /> Department: Animal Services Amount: $150 FY1617, $150 FY1718 Purpose: Veterinary Services Budget Code(s): <br /> 10215020 629003 Vendor# 52719 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract <br /> Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date Approved by Board YesE Not] <br /> Agenda Date: <br /> This agreement is approved as to technical fi rmdand content: <br /> Department Director's Signature 6t)I kturafto Date: 6/28/2017 <br /> '—C9B58115B7DD482... <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 of insurance standards, specifications, and requirements: <br /> DocuSiggned_by: <br /> 'll <br /> Office of the Risk Management Officer atsa rbri"- b Date: 6/28/2017 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in thsa p r4equired by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Office 1'l"'a `Z° 2°'L Date: 6/28/2017 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to le al form and sufficiency: <br /> ocuSigneed"by:' <br /> abtt L AtaVtt, 1SCb 6/28/2017 <br /> Office of the County Attorney Date: <br /> 079A4D525C0F4FB... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd(a,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 />