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DocuSign Envelope ID:23AA9521-5A8A-4D16-9A81-7143D7D4F7C3 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Chelsea Dawn Landon DVM Party/Vendor Contact Person: Chelsea Dawn Landon, DVM <br /> Contact Phone: 919-667-3229 PartyNendor Address: 3710 Cole Mill Road City Durham State: NC Zip: 27712 <br /> Department: Animal Services Amount: 999.99 Purpose: Veterinary Services Budget Code(s): 10215020 629003 <br /> Vendor 9 64867 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one) <br /> New ❑ Renewal ® Amendment ❑ Effective Date 07/01/2020 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 on <br /> this project has not been initiated prior to execution of the agreement: <br /> o M rJ <br /> Department Director's Signature[6' 8 d Date:6/19/2019 <br /> ca�sbns3�eo-lsz <br /> Agreements for emergency services or repau 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 was <br /> addressed: <br /> Information Technologies <br /> (Applicable only to hardwarelsofiware 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 /> ...wa,��d Iy: <br /> Office of the Risk Management OfficeCD <br /> usx (,b 6 Date.6/20/2019 <br /> 7mcr017MONgE. <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: [ <br /> Office of the Chief Financial Officer[ ` Date:6/21/2019 <br /> id1C8181ACC HOD�r.,e. <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> sd db,: <br /> Office of the County Attorney Q""-ftayi(,Tbso Date:6/21/2019 <br /> eraa;oszswrsn <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 /> orangecountync.gov <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> Office of the Cleric to the Board Date: <br /> Revised 12/18 4 <br /> s <br />