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DocuSign Envelope ID:BCE64A7F-AC28-4B03-BFA7-B9965384DA09 <br /> To: Dorothy Cilenti <br /> Cc: Rebecca Crawford; Donna King; Meredith McMonigle; Kimberlee Quatrone <br /> Subject: REQUEST: insurance waiver-Trish Tolbert <br /> Hi Dorothy, <br /> Ms. Tolbert is not an LLC and will be contracting with us as an individual. Can you please approve a waiver of the <br /> insurance requirement stipulated in the county contract template? <br /> Thanks! <br /> Coby <br /> Coby Jansen Austin, MPH <br /> Director of Programs and Policy <br /> Family Success Alliance& Board of Health <br /> Phone:919-245-2070/Fax:919-245-0896 <br /> improvg heckrh- in$0;ring Con re. <br /> You <br /> _. <br /> CONFIDENTIALITY NOTICE: All email messages, including any attachments, generated from or received by this site are the property <br /> of Orange County Government and are considered public domain subject to the North Carolina Public Record Law.The Orange County <br /> Health Department transmits minimal confidential client/patient information via email, and any unauthorized review, use,disclosure or <br /> distribution is prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the <br /> original message. If you believe there has been an inappropriate disclosure, please contact Carla Julian, OCHD HIPAA Privacy and <br /> Security Officer, at cju]ian©orangecountync.gov. <br /> From: Coby Austin <br /> Sent: Thursday, May 11, 2017 8:49 AM <br /> To: Kimberlee Quatrone; Dorothy Cilenti <br /> Cc: Rebecca Crawford; Donna King; Meredith McMonigle <br /> Subject: Contract request &insurance waiver-Trish Tolbert <br /> Hi Kim - Please see attached for the contract request for working with Trish Tolbert on development/fundraising <br /> technical assistance for Family Success Alliance. She feels more comfortable dropping off a hard copy of her W9, rather <br /> than sending it by email, since it includes her SSN. I copied you on an email to her with directions to your office, since I <br /> am offsite much of today and tomorrow. I'm including her resume not as part of the contract, but in case the county <br /> manager or anybody wants to see it. <br /> Dorothy—Ms.Tolbert is not an LLC and will be contracting with us as an individual. Can you please approve a waiver of <br /> the insurance requirement stipulated in the county contract template? <br /> Rebecca/Donna/Meredith—Just keeping you in the loop that I'm putting in this request. <br /> Coby <br /> 2 <br />