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DocuSign Envelope ID:26FFAC14-685F-4DB8-985B-761D8D052080 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Bethany Walters, DVM PartylVendor Contact Person: Bethany Walters, DVM_ Contact Phone: <br /> 919-614-3073 Party/Vendor Address: 4418 Cottendale Drive City Durham State: NC Zip: 27703 Department: <br /> Amimal Services Amount: 2,500 Purpose: Veterinary Services Budget Code(s): 10215020 629004 Vendor li NIA <br /> (NIA if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New ® Renewal <br /> ❑ Amendment ❑ Effective Date Octboer 1,2019 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 /> ❑ Se b,: <br /> �cb Awl 10/11/2019 <br /> Department Director's Signature Date: <br /> a=.sn-ssmndnn - <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 onl),to hardwarelsofhvare 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 /> ❑ 58 dhy <br /> Office of the Risk Management Office Q�s, �Z o Date:10/11/2019 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> ❑ s,z by: <br /> Office of the Chief Financial Officer11 <br /> A'/z'" [)i1c;10/11/2019 <br /> rns=s vinrndx <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> ❑ seq. b <br /> Office of the County Attorney Q"Lt` `fit tbsca Date:10/11/2019 <br /> 07gn .W;C.'.F'F; <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@orangecountyne.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 12119 4 <br />