HomeMy WebLinkAboutR 2015-398-E Health - Robert Dupuis to provide pharmacy services DocuSign Envelope ID: 7D9491 BE-DD6D-4897-B77A-CD2FD6CC19A7
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: ROBERT DUPUIS Party/Vendor Contact Person: ROBERT DUPUIS Contact Phone: 919-966-
4131 Party/Vendor Address: 205 KENILWORTH PLACE City CHAPEL HILL State: NC Zip: 27516 Department:
HEALTH Amount: $12,645 Purpose:PHARMACY SERVICES Budget Code(s): 10414020-630000 Vendor 4 47361
(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:
This agreement is approved as to to LR��hyid c ntent:
�-� �� 8/5/2015
Department Director's Signature Q�FC�s�a�- 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 o iiubaa >:standards, specifications,and requirements:
Qusa, r,6vvte& 8/5/2015
Office of the Risk Management Office Date:
Financial Services
This instrument has been pre-audited i ��hV P1 ired by the Local Government Budget and Fiscal Control Act:
qlA� M 8/6/2015
Office of the Chief Financial Officer Date:
Legal Services
This agreement is approved as t a4-f@la l sufficiency:
Office of the County Attorney 44� �1� Date: 8/7/2015
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloyLyorangecou go v
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 July 2015 4