HomeMy WebLinkAboutR 2017-423-E Health - David Hesselmeyer dba On Target Preparedness to assist Preparedness Coordinator with State addendum requirements DocuSign Envelope ID:4E69ED8B-92AC-4FBB-ADB6-1CO26BC83DOC
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: $5,000 Purpose: Assist Preparedness Coordinator with fullfilling state
addendum requirements Budget Code(s): 10414020-630000-71413 Vendor#63291 (N/A if new vendor) Vendor is
a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective
Date 9/15/17 Approved by Board Yes No Agenda Date:
This agreement is approved as to to x°81 lid content:
1orttu&1 8/21/2017
Department Director's Signature F14Fc2CO 45 4 F... Date:
Information Technologies
(Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is
approved as to information technology content and specifications:
Office of the Chief Information Officer Date:
Risk Management
This agreement is approved for sufficienc fq!P t ft_Y'staandards, specifications, and requirements:
((USA. rblet/ut16 8/22/2017
Office of the Risk Management Officer 7FDCF9176800498... Date:
Financial Services
This instrument has been pre-audited i e'?f'i'i�'ie$'lequired by the Local Government Budget and Fiscal Control 0...14,0x.0...14,0x.0°" � 8/28/2017 Act:
Office of the Chief Financial Officer i7D4E5181ACC1409... Date:
Legal Services
This agreement is approved as t e/g°a4�ld ` d sufficiency:
'" A. Al tl' SG6 8/28/2017
Office of the County Attorney o79A4D525coF4Fe__ 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 2/17 5