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DocuSign Envelope ID:7C495125-6619-47FC-AA13-CEF385D97245 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: David Hesselmeyer dba On Target Preparedness Party/Vendor Contact Person: David <br /> Hesselmeyer Contact Phone: 910-214-4086 Party/Vendor Address: 266 Braddock Drive City Lillington State: NC <br /> Zip: 27546 Department: Health Amount: $2,500 Purpose: Assist Preparedness Coordinator with fulfilling state <br /> addendum requirements Budget Code(s): 10414020-630000-71413 Vendor#63291 (N/A if new vendor) Vendor is <br /> a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective <br /> Date 7-1-19 Approved by Board Yes❑No❑ 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 /> S&Wof 7/16/2019 <br /> Department Director's Signature 3C18F2D09E3445F. Date: <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 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 sufficient oocusigneda LQ_by:.� ' .rds,specifications,and requirements: <br /> aUs 6 7/17/2019 <br /> Office of the Risk Management Office Datc: <br /> 7FDCF9178800498. <br /> Financial Services <br /> This instrument has been pre-audited:1r7D4E5181A=4G0 <br /> DocuSigned by: the Local Government Budget and Fiscal Control Act: <br /> 7/17/2019 <br /> Office of the Chief Financial Office . Date: <br /> Legal Services <br /> This agreement is approved as t DocuSigned by: <br /> § �WVk t, �S� 7/17/2019 <br /> Office of the County Attorney 079A4D525C0F4Fa. Date: <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 />