HomeMy WebLinkAboutR 2015-418-E Health - Piedmont Health Services for dietitian services DocuSign Envelope ID: 314390E1-681E-443D-93AA-18AFB7BE38D8
ORANGE COUNTY—DEPARTMENT USE ONLY
Deuartment
Party/Vendor Name: PIEDMONT HEALTH SERVICES Party/Vendor Contact Person: LYNELL HODGES
Contact Phone: 919-942-8741 x1482 Party/Vendor Address: PO BOX 17179 City CHAPEL HILL State: NC
Zip: 27516 Department: HEALTH Amount: $33,000 Purpose: DIETITIAN Budget Code(s): Vendor 4
27898 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one)New ❑
Renewal❑ Amendment ❑ Effective Date Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to to Wnd content:
b� 8/6/2015
Department Director's Signature �eaBO��e 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 Dia,%iiaa Q,:standards,specifications,and requirements:
��FBC-H-1-7&H iSa /
� 8 6/2015
Office of the Risk Management Office oa Date:
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act: DocuSigned by:
Office of the Chief Financial Officer vu Date: 8/11/2015
Legal Services
This agreement is approved as t Rtgltfg l sufficiency:
L 44�j 1��
Office of the County Attorneys Date: 8/11/2015
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
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