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DocuSign Envelope ID:72D276E7-8F57-4025-B4DE-37E18OCE2BOD <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Claudia Sheppard DVM Party/Vendor Contact Person: Claudia Sheppard Contact Phone: <br /> 919-933-0713 Party/Vendor Address: 101 Autumn Lane City Chapel Hill State: NC Zip: 27516 Department: <br /> Animal Services Amount: up to$4L000 Purpose: Provide Vet Care Budget Code(s): 10215020 629004 10215020 <br /> 629010 Vendor# 52719 (NIA if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: <br /> (Check one)New ❑ Renewal ® Amendment ❑ Effective Date 07/01/2019 Approved by Board Yes❑No <br /> ❑ Agenda hate: <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 /> ❑ocuSigned by <br /> Department Director's Signature[C'111��l Date:6/28/2019 <br /> Agreements for emergency services or rir'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 hardwarelsoftware 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 Mana ement <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> C�OuSig ned byOffice of the Risk Management Office ALL& bYtn,Ab 6/28/2019 <br /> 7F❑CF61762QCd@9. 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 /> ❑acuSig ned by: <br /> Office of the Chief Financial Officer) 0"� Date: 6/30/2019 <br /> 7P1 Ei18'ACC1�Ofl <br /> Legal Services }} <br /> This agreement is approved as to legal form and sufficiency: <br /> ❑ 5'g ed by: <br /> Office of the County Attorney `fir ) b Date. 7/1/2019 ? <br /> O'S.B.t❑52uL'hF4F6.. --- <br /> i <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: snngersoll@orangecountyne.gov f <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 /> 7 i <br /> Rev. 6119 <br /> I <br />