HomeMy WebLinkAboutR 2015-635-E Health - David Hesselmeyer dba On Target Preparedness - Preparedness Coordinator DocuSign Envelope ID:2F28EB01-83FA-4053-9050-C31 E0BA4EBA9
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: David Hesselmeyer dba On Target Preparedness Party/Vendor Contact Person: David
Hesselmeyer Contact Phone: 910-214-4086 Party/Vendor Address: 266 Braddock Drive City Lillington State:NC
Zip: 27546 Department: Health Amount: $20.000 Purpose: Assume duties of Preparedness Coordinator Budget
Code(s): 10414020-630000-71413/71421 Vendor# 63291 (N/A if new vendor) Vendor is a BOCC consultant?
Yes ❑ No Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 12/28/15
Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to to vagumnytined content:
Department Director's Signature
CFC66545E Date: 12/18/2015
...
Information Technologies
(Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is
approved as to information technology content and specifications:
Office of the Chief Information Officer Date:
Risk Management
This agreement is approved for sufficienc I iiusorangostandards, specifications,and requirements:
((USA COVI/ut t 12/19/2015
Office of the Risk Management Officer 7FfCF916R004QR Date:
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act: DocuSigned by:
(2141., Arudehort
Office of the Chief Financial Officer Date: 12/20/2015
7 n4G5a.84ACC-140.9 .
Legal Services
This agreement is approved as toel-egAlletineaki sufficiency:
y
Office of the County Attorney Date: 12/21/2015
"� ` 103CCB8301Cn1A9...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecountync.gov
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board Date:
Revised 10/14
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