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DocuSign Envelope ID:4E69ED8B-92AC-4FBB-ADB6-1CO26BC83DOC <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: David Hesselmeyer dba On Target Preparedness Party/Vendor Contact Person: David <br /> Hesselmeyer Contact Phone: 910-214-4086 Party/Vendor Address: 266 Braddock Drive City Lillington State: NC <br /> Zip: 27546 Department: Health Amount: $5,000 Purpose: Assist Preparedness Coordinator with fullfilling state <br /> addendum requirements Budget Code(s): 10414020-630000-71413 Vendor#63291 (N/A if new vendor) Vendor is <br /> a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective <br /> Date 9/15/17 Approved by Board Yes No Agenda Date: <br /> This agreement is approved as to to x°81 lid content: <br /> 1orttu&1 8/21/2017 <br /> Department Director's Signature F14Fc2CO 45 4 F... Date: <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficienc fq!P t ft_Y'staandards, specifications, and requirements: <br /> ((USA. rblet/ut16 8/22/2017 <br /> Office of the Risk Management Officer 7FDCF9176800498... Date: <br /> Financial Services <br /> This instrument has been pre-audited i e'?f'i'i�'ie$'lequired by the Local Government Budget and Fiscal Control 0...14,0x.0...14,0x.0°" � 8/28/2017 Act: <br /> Office of the Chief Financial Officer i7D4E5181ACC1409... Date: <br /> Legal Services <br /> This agreement is approved as t e/g°a4�ld ` d sufficiency: <br /> '" A. Al tl' SG6 8/28/2017 <br /> Office of the County Attorney o79A4D525coF4Fe__ Date: <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 />