Orange County NC Website
Browse       Search
DocuSign Envelope ID: 047E674E- OBA4- 40EA- A551- 59FD7A408776 <br />ORANGE COUNTY — DEPARTMENT USE ONLY <br />Department <br />Party/Vendor Name: Phillip Roundtree Party/Vendor Contact Person: Phillip Roundtree Contact Phone: 267 -648- <br />7022 Party/Vendor Address: 2053 McKinley Street City Philadelphia State: PA Zip: 19149 Department: Health <br />Amount: 1,000 Purpose: Suicide Prevention Week Walk Speaker Budget Code(s): 10412020 - 680007 -71451 Vendor <br /># 65283 (N /A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New <br />Renewal ❑ Amendment ❑ Effective Date 9 -1 -18 Approved by Board Yes❑ No❑ Agenda Date: <br />This agreement is approved as to to 'ft4 Mid content: <br />I�v�A" skwat'i 8/20/2018 <br />Department Director's Signature c �soa�F14�AS 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 <br />Risk Management <br />Date: <br />This agreement is approved for sufficienc @am c ""ays''tl1al1ndards, specifications, and requirements: <br />Q�tSA. r,Ovv�,�j0 <br />Office of the Risk Management Officer Date: 8/20/2018 <br />Financial Services <br />This instrument has been pre - audited i &fflh% ' �Lquired by the Local Government Budget and Fiscal Control Act: <br />r�� 8/20/2018 <br />Office of the Chief Financial Officer Date: <br />Legal Services <br />This agreement is approved as t t0d�Md sufficiency: <br />L AAY'tt, TSC4 8/20/2018 <br />Office of the County Attorney Date: <br />Clerk to the Board <br />Received for record retention: <br />All Docusign contracts must be copied to Sherri Ingersoll upon completion: sineersoll(&oran eg countync. og_v <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 <br />Revised 10/17 (Mgr appry 5k 6/18) 4 <br />Date: <br />