HomeMy WebLinkAboutR 2015-141-E Co. Mgr. - UnitedHealthCare of NC - Amendment to Excess Loss Insurance Policy i
DocuSign Envelope ID: 7DB9202D-FDA8-426E-8A84-EAE7538E9310
ORANGE COUNTY-DEPARTMENT USE ONLY
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Department
Party/Vendor Name: UnitedHealthcare of NC Party/Vendor Contact Person: Patricia Martin Contact Phone: 919-
840-3106 Party/Vendor Address: 3131 RDU Center Drive City Morrisville State: NC Zip: 27560 Department:
Amount: $635,758.00 Purpose: UnitedHealthcare Excess Loss Insurance Policy Amendment Budget
Code(s): Vendor#47140 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract
Type: (Check one)New❑ Renewal ❑ Amendment M Effective Date 1/1/2015 Approved by Board Yes®
No❑ Agenda Date: 9/17/2013
This agreement is approved as to t Bali f „and content:
Department Director's Signatu Date: 2/19/2015
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Information Technologies
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(Applicable only to hardware/software patrchases 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:
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Risk Management
This agreement is approved for sufficiency of i3§A%WP1*andards,specifications,and requirements: k
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Office of the Risk Management Officer Date: 2/20/2015
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Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act: LP uSigned by:
Office of the Chief Financial Officer tA+6 u Date: 2/21/2015
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Legal Services
This agreement is approved as to�eg9Pf611ffAhd sufficiency:
Office of the County Attorneys Date: 2/23/2015
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Clerk to the Board
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Received for record retention: r
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@oran eg coup nc.gov
The following signature block is for hard copies only and is not required for Docusign contracts:
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Office of the Clerk to the Board Date:
Revised 10/14 9