HomeMy WebLinkAboutR 2017-036-E Health - David Hesselmeyer dba On Target Preparedness assist Preparedness Coordinator DocuSign Envelope ID:Al62B0D1-AC30-4C85-B533-0C40F1Al9433
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: $4,000 Purpose: Assist Preparedness Coordinator with fullfilling state
addendum requirements Budget Code(s): 10412020-630000-71413 Vendor#63291 (N/A if new vendor) Vendor is
a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective
Date 1/15/17 Approved by Board Yes No Agenda Date:
This agreement is approved as to to n aaid, nt:
(� 1/24/2017
Department Director's Signature c9ED9DOFCiB545E... Date:
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 sufficiency 4fisatW '_�vstandards,specifications,and requirements:
aMtSA. rbvvutl6 1/24/2017
Office of the Risk Management Officer 7FDCF917e800408 Date:
Financial Services
This instrument has been pre-audited i t eVi e`rbFequired by the Local Government Budget and Fiscal Control Act:
� p ` n '`°` 1/24/2017
Office of the Chief Financial Officer 7D4E5181ACC1409... Date:
Legal Services
This agreement is approved as tq(IggRPGItbsiWaPX:1 sufficiency:
1/24/2017
Office of the County Attorney \--4035CB8304CA4Ae... Date:
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 6/16 5