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DocuSign Envelope ID:7CD07906-463A-47D7-B030-F7EB5FA20DCB <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Tamara Freedman Party/Vendor Contact Person: Contact Phone: Party/Vendor <br /> Address: 174 Torain Street City Hillsborough State:NC Zip: 27278 Department: Aging Amount: $500.00 Purpose: <br /> Acupuncture Budget Code(s): 29430320-630000 Vendor # N/A (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes ❑ No❑ Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date March <br /> 11,2019 Approved by Board Yes❑Nor-1 Agenda Date: <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work on <br /> this project has not been initiated prior to execution of the agreement: <br /> DocuSigned by:: <br /> Department Director's Signatu �ctln.i�t, Date:3/11/2019 <br /> Agreements for emergency servic' B7E962❑1BF454FA.. abject to the above affirmation. If services related to this <br /> agreement have already begun or been completed please briefly describe the nature of the emergency condition that was <br /> addressed: <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 /> DocuSigned by: <br /> Office of the Risk Management Office QU56 3/11/2019 <br /> �,4Wt.t,{�6 Date: <br /> 7FDCF917e800498. <br /> Financial Services <br /> This instrument has been pre-audited in the manner reauired by the Local Government Budget and Fiscal Control Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Officerlr7NE5181ACC1409 <br /> 3/13/2019 <br /> Date: _ <br /> . <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> C_ <br /> DocuSigned by: <br /> Office of the County Attorn Date: <br /> 3/14/2019 <br /> 4035CB8304CA4M <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@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 12/18 4 <br />