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DocuSign Envelope ID:94A92ACC-5497-4AF7-8E1 E-3D796D10A80A <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: James Wise Party/Vendor Contact Person: James Wise Contact Phone: (919)929-2106 x41270 <br /> Party/Vendor Address: 2324 Woodbury Drive City Hillsborough State: NC Zip: 27278 Department: Health Amount: <br /> $500 Purpose: TRU Advisor Budget Code(s): 10412020-630000-71454 Vendor # 57567 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ <br /> Effective Date August 1,2017 Approved by Board Yes No Agenda Date: <br /> This agreement is approved as to to n c fffid d��content: <br /> bV0 t�VUt 9/11/2017 <br /> Department Director's Signature F14Fczrnoacreor... 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 sufficient q 4x�rt tsatrggwstandards,specifications,and requirements: <br /> ltuSa C,.V ktffb 9/11/2017 <br /> Office of the Risk Management Officer 7FDcp017sR(114QR Date: <br /> Financial Services <br /> This instrument has been pre-audited i t eD I P quired by the Local Government Budget and Fiscal Control Act: <br /> (71.4., `�°" '`x. 9/11/2017 <br /> Office of the Chief Financial Officer 7D4E5181ACC1409... Date: <br /> Legal Services <br /> This agreement is approved as t 1cf6 d sufficiency: <br /> l/UAA. ham- 1 SG6 9/11/2017 <br /> Office of the County Attorney 070n4D625c0r4ra... 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 />