HomeMy WebLinkAboutR 2016-108 Health - UNC School of Dentistry for resident dental services
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: UNC School of Dentistry Party/Vendor Contact Person: Martha Barbour Contact Phone:
919-537-3570 Party/Vendor Address: CB #7450 City Chapel Hill State: NC Zip: 27599 Department: Health
Amount: $58,445 Purpose: Resident dental services Budget Code(s): 10410120-630000 Vendor#36302 (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 technical fprm and content:
Department Director's Signature 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 sufficiency of insurance standards,specifications,and requirements:
Office of the Risk Management Officer_: Date:l�
Financial Services
This instrument has been pre-audited in the er require by the Local Government Budget and Fiscal Control
Act:
Office of the Chief Financial Officer Date:
Legal Services
1
This agreement is approved as to legs and ffi 'ency:
Office of the County Attorney Date:
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydgoran eg countync•g_o_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: