HomeMy WebLinkAboutR 2015-426-E Health - Walgreen, Co. for Diabetes Self-Management Education Program DocuSign Envelope ID:82FA214D-F8D2-4F89-9551-89D21AOA870C
ORANGE COUNTY-DEPARTMENT USE ONLY
Deuartment
Party/Vendor Name: Walgreen Co. Party/Vendor Contact Person: Dana Petri Contact Phone: 919-942-8738
Party/Vendor Address: 1106 Environ WE City Chapel Hill State: NC Zip: 27517 Department: Health Amount:
$600.00 Purpose: Group in Budget Code(s): 10414020-630000-71405 Vendor 4 62867 (N/A if new vendor)
Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ❑ Renewal ® Amendment ❑
Effective Date 7/1/15 Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to f ?to pp o ,t-t-la.If rand content:
�,
Department Director's Signature Date: 8/12/2015
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 sufficient g9V9a' standards,specifications,and requirements:
Q�ASA r,6vvte tt0 8/12/2015
Office of the Risk Management Office _EncF_cLtzaa0DAga Date:
Financial Services
This instrument has been pre-audited i �sl�>� gLuired by the Local Government Budget and Fiscal Control Act:
�A.U�, 8/12/2015
Office of the Chief Financial Officer e� Date:
Legal Services
This agreement is approved as t eg��Aff'1aWd sufficiency:
1 8/12/2015
Office of the County Attorney a��s gA��, oaoa Date:
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 10/14 5