HomeMy WebLinkAboutR 2016-268-E Health - Maxim Physician Resources, LLC for temp nurse staff services DocuSign Envelope ID:6EB7A98E-7386-481D-BB68-D6A5BBAODDCB
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Maxim Physician Resources, LLC Party/Vendor Contact Person: Laird Dunham Contact
Phone: 972-729-2571 Party/Vendor Address: 5001 LBJ Freeway. Suite 900 City Dallas State: TX Zip: 75244
Department: Health Amount: $30.000 Purpose: Temp nurse staff services Budget Code(s): 10414020-630000
Vendor#N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No[] Contract Type: (Check one)
New ® Renewal ❑ Amendment ❑ Effective Date 5-23-16 Approved by Board Yes❑ No❑ Agenda
Date:
This agreement is approved as to to P,q1°ff did content:
Department Director's Signature Date:
5/26/2016
Information Technolosies
(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 sufficienc %WwRaystandards, specifications,and requirements:
Q�Sa r,6�6 5/26/2016
Office of the Risk Management Officer ,FncE917unnags 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 Date: 5/26/2016
Legal Services
This agreement is approved as to(fug0Pf&WrWhd sufficiency:
Office of the County Attorney 4,— Date: 5/27/2016
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydkorangecount.nic.gov
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 1/16
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