HomeMy WebLinkAboutR 2014-566 Health - Rachel Sigmon for Dental Services $35,000
DocuSign Envelope ID: EB453E96-2633-4D28-B133-0C9F1E02F8CB
ORANGE COUNTYDEPARTMENT USE ONLY
______________________________________________________________________________
Department
Party/Vendor Name: Rachel Sigmon Party/Vendor Contact Person: Rachel Sigmon Contact Phone: (336) 587-5155
Party/Vendor Address: 4045 Cleburne Court City: Haw River State: NC Zip: 27258 Department: Health Amount:
$35,000 Purpose: Dental Services Budget Code(s): 10410120- 630000 Vendor # N/A (N/A if new vendor) Vendor is
a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date
11/1/14 Approved by Board Yes No Agenda Date:
This agreement is approved as to technical form and content:
________________________________________ 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 Officer________
___________________________ Date: ________
Risk Management
This agreement is approved for sufficiency of insurance standards, specifications, and requirements:
Office of the Risk Management Officer
___________________________________ Date: _________
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 Officer
____________________________________ Date: _________
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney
__________________________________________Date: ________
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@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:_________
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