HomeMy WebLinkAboutR 2019-782 Animal Svc - Amanda Chapman DVM veterinary services DocuSign Envelope ID: ED70ABD7-FFE4-4C25-B3D1-84A819C70CE2
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Amanda Chapman, DVM Party/Vendor Contact Person: Amanda Chapman, DVM Contact
Phone: 920-246-2592 Party/Vendor Address: 104 Mullin Court City Chapel Hill State:NC Zip: 27514 Department:
Amimal Services Amount: 999.99 Purpose: Veterinary Services Budget Code(s): 10215020 629004 Vendor#
(N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New ❑ Renewal
® Amendment ❑ Effective Date July 1,2019 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:
❑ s,� M:
Department Director's Signature Date:10/21/2019
:na�ei;a�nndnn
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 sufficiency of insurance standards, specifications,and requirements:
❑ 58 dhy
Q�Sa fan 6 10/22/2019
Office of the Risk Management Office Date:
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
❑ sated ny:
� 10/22/2019
Office of the Chief Financial OfficerI o� Date:
rns=s vinrndx
Legal Services
This agreement is approved as to legal form and sufficiency:
❑ se�ny
Qln. k lt.arr�."6scn 10/22/2019
Office of the County Attorne Date:
{1]nk1n5+=C0F4FR
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