HomeMy WebLinkAboutR 2018-453 Health - Philip Roundtree Suicide Prevention Week Walk SpeakerDocuSign Envelope ID: 047E674E- OBA4- 40EA- A551- 59FD7A408776
ORANGE COUNTY — DEPARTMENT USE ONLY
Department
Party/Vendor Name: Phillip Roundtree Party/Vendor Contact Person: Phillip Roundtree Contact Phone: 267 -648-
7022 Party/Vendor Address: 2053 McKinley Street City Philadelphia State: PA Zip: 19149 Department: Health
Amount: 1,000 Purpose: Suicide Prevention Week Walk Speaker Budget Code(s): 10412020 - 680007 -71451 Vendor
# 65283 (N /A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New
Renewal ❑ Amendment ❑ Effective Date 9 -1 -18 Approved by Board Yes❑ No❑ Agenda Date:
This agreement is approved as to to 'ft4 Mid content:
I�v�A" skwat'i 8/20/2018
Department Director's Signature c �soa�F14�AS 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
Risk Management
Date:
This agreement is approved for sufficienc @am c ""ays''tl1al1ndards, specifications, and requirements:
Q�tSA. r,Ovv�,�j0
Office of the Risk Management Officer Date: 8/20/2018
Financial Services
This instrument has been pre - audited i &fflh% ' �Lquired by the Local Government Budget and Fiscal Control Act:
r�� 8/20/2018
Office of the Chief Financial Officer Date:
Legal Services
This agreement is approved as t t0d�Md sufficiency:
L AAY'tt, TSC4 8/20/2018
Office of the County Attorney Date:
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Sherri Ingersoll upon completion: sineersoll(&oran eg countync. og_v
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board
Revised 10/17 (Mgr appry 5k 6/18) 4
Date: