HomeMy WebLinkAboutR 2015-363-E HR - Flores & Associates, LLC - Medical Reimbursement and Dependent Care Asst. Claim Admin. Agreement DocuSign Envelope ID: EA6C45CD-7691-43D8-B939-A4300A7DD233
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Flores&Associates,LLC Party/Vendor Contact Person: Mario Flores Contact Phone: 800-532-
3327 Party/Vendor Address: 1218 S. Church Street City Charlotte State: NC Zip: 28203 Department:
Amount: $0.00 Purpose: Medical Reimbursement and Dependent Care Assistance Claim Administration Agreement
Budget Code(s): Vendor # (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No®
Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 7/1/2015 Approved by Board
Yes❑No® Agenda Date:
D c Si ned b
This agreement is approved as to tec 1�a ark' copter}t:�
�'j 7/15/2015
Department Director's Signature PC98D269F0148F... Date:
Information Technologies
(Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is
approved as to information technology content and specifications:
Office of the Chief Information Officer Date:
Risk Management
This agreement is approved for sufficient 4ISIff" �""�yWaLidards,specifications,and requirements:
Qllsa bvvte& 7/22/2015
Office of the Risk Management Officer 7FDCF9176800498... Date:
Financial Services
This instrument has been pre-audited i r Off�t�iup$, iced by the Local Government Budget and Fiscal Control Act:
q� �M 7/22/2015
Office of the Chief Financial Officer 232DFFC2CFA8476 Date:
Legal Services
This agreement is approved as t le Da fc' dAd sufficiency:
l \ 7/28/2015
Office of the County Attorney 4035C68304CA4A9.. Date:
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloydLyoran ecoun nc.g
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board Date:
Revised 10/14 4