HomeMy WebLinkAboutR 2015-557 Health - UNC Department of Family Medicine for Medical Director services2015-557
ORANGE COUNTY-DEPARTMENT USE ONLY l
Department
Party/Vendor Name: UNC Department of Family Medicin Party/Vendor Contact Person: Pam Hoover
Contact Phone: 919-966-3907 Party/Vendor Address: 590 Manning Drive City Chapel Hill State:NC Zip:27599
Department: Health Amount: $145,416 Purpose: Medical Director Services Budget Code(s): 10414020-630000-
71400/71403/71406/71409/71414/71416 Vendor#21243 (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[]Non Agenda Date:
This agreement is approved as to technical form and content:
Department Director's Signature Date: s
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 insurance standards,specifications,and requirements:
Office of the Risk Management Officer 1/ Date: /61,- Z h j
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act: �
Office of the Chief Financial Officer I ! QI M Date:AD
G
Legal Services
This agreement is approved as to lega f d s cy:
Office of the County Attorney Date: 1 0 L�
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydaa,oran eg count cc og_v
The following signature block is for hard c 'es o d is not required for Docusign contracts:
Office of the Clerk to the Board Date: to
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