Orange County NC Website
Revised 11/19 <br />8 <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br /> <br />Party/Vendor Name: JVR Shelter Strategies Party/Vendor Contact Person: Jyothi Robertson Contact Phone: 605- <br />274-7082 Party/Vendor Address: 1025 Alameda de las Pulgas No.333 City Belmont State: CA Zip: 94002 <br />Department: Animal Services Amount: $6,000 Purpose: Veterinary Health Consulting Budget Code(s): 10215020 <br />630000 Vendor # 66005 (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: <br />(Check one) New Renewal Amendment Effective Date 7/1/2020 Approved by Board Yes No <br />Agenda Date: <br /> <br /> <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 /> <br /> <br />Department Director’s Signature ________________________________________ 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 <br />was addressed: <br /> <br /> <br />Risk Management <br /> <br />This agreement is approved for sufficiency of insurance standards, specifications, and requirements: <br /> <br />Office of the Risk Management Officer___________________________________ Date: _________ <br /> <br /> <br />Financial Services <br /> <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br />Act: <br /> <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br /> <br /> <br />Legal Services <br /> <br />This agreement is approved as to legal form and sufficiency: <br /> <br />Office of the County Attorney __________________________________________Date: ________ <br /> <br /> <br />Clerk to the Board <br /> <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 /> <br />Office of the Clerk to the Board __________________________________________Date:_________ <br /> <br /> <br /> <br />DocuSign Envelope ID: F2331C77-666B-4669-8946-6EBDFDE04417 <br />9/15/2020 <br />9/16/2020 <br />9/16/2020 <br />10/9/2020