HomeMy WebLinkAboutR 2014-534 Health - Lesly Veronica Penick - Amendment to Services Agreement ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Lesly Penick Party/Vendor Contact Person: Contact Phone: 919-274-4530
Party/Vendor Address: 221 Adams Street City: State: NC Zip: 27513 Department: Health Amount:
Purpose: Budget Code(s): Vendor# 58092 (N/A if new vendor) Vendor is a BOCC consultant?
Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ❑ Amendment ® Effective Date 10/17/2014
Approved by Board Yes❑Non Agenda Date:
This agreement is approved as to technical form and it
Department Director's Signature �... Date:
1n n 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 Director of Information Technology Date:
Risk Management D � � � 0
This agreement is approved for sufficiency of insurance standards,specifications,and requirem
OCT 1 6 2014
Office of Risk Management _ t �_�..� Date:
101 L10 By
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act:
Office of the Chief Financial Officers Date:
t0��
Lesal Services
This agreement is approved as to lega and sufficiency:
Office of the County Attorney Date: O 28
Clerk to the Board
Received for record retention:
Office of the Clerk to the Board Date: