HomeMy WebLinkAboutR 2019-466 Health - David Hesselmayer preparedness coordinator assistance DocuSign Envelope ID:7C495125-6619-47FC-AA13-CEF385D97245
ORANGE COUNTY—DEPARTMENT USE ONLY
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: $2,500 Purpose: Assist Preparedness Coordinator with fulfilling 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 7-1-19 Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to technical form and content and I as Department Director affirmatively state work on
this project has not been initiated prior to execution of the agreement:
DocuSigned by:
S&Wof 7/16/2019
Department Director's Signature 3C18F2D09E3445F. Date:
Agreements for emergency services or repair are not subject to the above affirmation. If services related to this
agreement have already begun or been completed please briefly describe the nature of the emergency condition that was
addressed:
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 sufficient oocusigneda LQ_by:.� ' .rds,specifications,and requirements:
aUs 6 7/17/2019
Office of the Risk Management Office Datc:
7FDCF9178800498.
Financial Services
This instrument has been pre-audited:1r7D4E5181A=4G0
DocuSigned by: the Local Government Budget and Fiscal Control Act:
7/17/2019
Office of the Chief Financial Office . Date:
Legal Services
This agreement is approved as t DocuSigned by:
§ �WVk t, �S� 7/17/2019
Office of the County Attorney 079A4D525C0F4Fa. Date:
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@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 12/18 4