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DocuSign Envelope ID: B1973876-87EE-498D-AA8D-5852F1A5F3B2 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Vanderbilt University Party/Vendor Contact Person: Jacques Morin Contact Phone: 919 <br /> 5255075 Party/Vendor Address: 1205 Hillsborough Rd. City Chapel Hill State:NC Zip:27514 <br /> Department: Emergency Services Amount: N/A Purpose: Data Use Agreement Budget Code(s): N/A Vendor# <br /> N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New <br /> Renewal❑ Amendment ❑ Effective Date_June 13,2019 Approved by Board Yes❑No® Agenda <br /> Date: <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work <br /> on this project has not been initiated prior to execution of the agreement: <br /> LDOCUSigned by: <br /> 5655BC89IA64473 <br /> t� �t is 6/14/2019Department Director's Signatur Date: <br /> . <br /> Agreements for emergency services or repair are not subject 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 <br /> was 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 /> Office of the Risk Management Officer Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: <br /> Office of the Chief Financial Officer Date: <br /> Legal Services <br /> This agreement is approved as b 'E4c035CB8304CA4M <br /> ousigned by: ;ncy: <br /> Office of the County AttorneyDate:6/17/2019 <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 /> 4 <br />