HomeMy WebLinkAboutR 2015-315-E DSS - UNC Hospital to provide one full time IMC and one part-time supervisor DocuSign Envelope ID: 58D1CF8D-AFE2-4E9F-83A1-A478FC8BEB36
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: UNCH Party/Vendor Contact Person: J.J Campbell Contact Phone: (919) 966-7029
Party/Vendor Address: 101 Manning Dr City Chapel Hill State: NC Zip: 27278 Department: DSS Amount:
$49,587 Purpose: Provide one full time IMC and one wart-time supervisor Budget Code(s): 10403005-442311
Vendor# (NIA if new vendor) Vendor is a BOCC consultant? Yes❑ No❑ Contract Type: (Check one)
New ❑ Renewal ® Amendment ❑ Effective Date 07/01/15 Approved by Board Yes® No[:] Agenda
Date:
This agreement is approved as to technical form @ft�t Xrjed by:
N. �y C0,40A
Department Director's Signature 9.4E E-146A@8B4b5 Date: 6/29/2015
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 ins T7EeF;917a800,t dig;&I ys'peecifications,and requirements:
r,6Vlit b 6/29/2015
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: DocuSigned by:
�MAL to D""`bvu 7/6/2015
Office of the Chief Financial Officer 232ni Date:
Legal Services
This agreement is approved as to legal form and J�,ffl,,Siq,ned by:
Office of the County Attorney Date: 7/6/2015
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dollo dnoran ecount nc, ov
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board Date: