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O docusign <br />Certificate Of Completion <br />Envelope Id: DA3FE4F5-F342-4945-ABB4-BEED2F41C301 <br />Status: Sent <br />Subject: Complete with Docusign: Agreement(APPROVED) - 4328687 - COUNTY OF <br />INDIAN RIVER - BOARD OF COUNT... <br />Source Envelope: <br />Document Pages: 3 Signatures: 1 <br />Envelope Originator: <br />Certificate Pages: 5 Initials: 0 <br />Gabrielle Mielz <br />AutoNav: Enabled <br />3050 Science Park Drive <br />Envelopeld Stamping: Enabled <br />Beachwood, OH 44122 <br />Time Zone: (UTC -05:00) Eastern Time (US & Canada) <br />mielzg@ccf.org <br />IP Address: 10.101.81.73 <br />Record Tracking <br />Status: Original Holder: Gabrielle Mielz Location: DocuSign <br />5/1/2025 5:18:41 PM mielzg@ccf.org <br />Si ner Events Sl n <br />g gn ature ,.. _ _ �...Tlmestamp <br />Kellie Hensley Eftg .d by: Sent: 5/1/2025 5:19:30 PM <br />henslek3@ccf.orgViewed: 5/5/2025 7:12:02 AM <br />Regional Sr. Director of Community AF04AD932Ae24c,... Signed: 5/5/2025 7:12:52 AM <br />Security Level: Email, Account Authentication Freeform Signing <br />(None) Signature Adoption: Pre -selected Style <br />Using IP Address: 73.56.92.245 <br />Signed using mobile <br />Electronic Record and Signature Disclosure: <br />Not Offered via Docusign <br />Michelle Wagner Sent: 5/5/2025 7:12:53 AM <br />mwagner@indianriver.gov Viewed: 5/12/2025 10:59:48 AM <br />Security Level: Email, Account Authentication <br />(None) <br />Electronic Record and Signature Disclosure: <br />Accepted: 5/12/2025 10:59:48 AM <br />ID:fc24bfab-5805-43d7-a9c4-7820f3d65edd <br />In Person Signer Events Signature Tlmestamp <br />Editor Delivery Events Status _ 'Timestamp <br />Agent.Delivery Events Status , Tlmestamp• <br />- - - - <br />IntermediaryDeliveryEvents. Status ,Tlmestamp <br />Certified Delivery Events Status = Timestamp <br />Carbon Copy Events Status = Timestamp <br />Law Department <br />CMSEvents@ccf.org <br />Security Level: Email, Account Authentication <br />(None) <br />Electronic Record and Signature Disclosure: <br />Not Offered via Docusign <br />