HomeMy WebLinkAboutR 2016-215 ES - UNC for Medical Director's contract abl 6�a �
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: UNC Party/Vendor Contact Person: Ed Jackem Contact Phone: 919 843-2611
Party/Vendor Address: 170 Manning Dr. CB# 7594, City_ Chapel Hill State: _ NC Zip:
27599-7594 Department: Emergency Services Amount: 51,700 Purpose: Medical Director's
Contract Budget Code(s): 10757520630000 Vendor#26130 (N/A if new vendor) Vendor is a BOCC
consultant? Yes ❑No® Contract Type: (Check one)New ❑ Renewal ® Amendment ❑ Effective
Date July 1,2015 Approved by Board Yes❑No® Agenda Date:
This agreement is approved as to technical form an content: T_
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 C' � -'—' Date:
Financial Services
This instrument has been pre-audited in the arequi e Loc al Government Budget and Fiscal
Control Act: d
Office of the Chief Financial Officer Date: 16 I C
Leeal Services
This agreement is approved as to legal and ciency:
Office of the County Attorney Date: (o
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@oranaecountync.gov
The following signature block is for hard copies only and is not required for Docusign contracts:
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Office of the Clerk to the Board Date:
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