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DocuSign Envelope ID:881484B7-44A8-4DD9-9947-6209CB23CD79 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Patagonia Party/Vendor Contact Person: Amos Slate Contact Phone: 919-439-0964 <br /> Party/Vendor Address: 15100 Weston Parkway#204 City CM State: NC Zip: 27513 Department: Health <br /> Amount: $22,155 Purpose: Extend existing contract on month-by-month basis for Pharmacy app and full data <br /> extraction. Budget Code(s): 10414020-630000 & 61370035-800100-30012 Vendor# 61583 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New ❑ Renewal ❑ Amendment <br /> Effective Date 10-1-19 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 /> 6iK na ' S&W 9/9/2019 <br /> Department Director's Signature Date: <br /> 3C16F2D09E3445F. <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 co DocuSigned by:- ons: <br /> Office of the Chief Information Officer ,�tm 4"y C116A91E73A64DF.. Date: 9/16/2019 <br /> Risk Management <br /> This agreement is approved for sufficient -oocuSigned by: rds,specifications,and requirements: <br /> USX �,bV1n.t,{�6 9/16/2019 <br /> Office of the Risk Management Officer 7FDCF9170800L98. Date: <br /> Financial Services <br /> This instrument has been pre-audited i Docusigned by: the Local Government Budget and Fiscal Control Act: <br /> 9/17/2019 <br /> Office of the Chief Financial Office 7NE5181ACC1409. Date: <br /> Legal Services <br /> This agreement is approved as tcg x D"USigned by: <br /> �S(h <br /> Office of the County Attorney Date: 9/18/2019 <br /> 079A4D525C0F4FB. <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 <br />