HomeMy WebLinkAboutR 2016-341-E Health - Piedmonth Health Services for registered dietitian services DocuSign Envelope ID: FFA19DOA-84C4-4BDE-9282-726EAF96A3F6
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: PIEDMONT HEALTH SERVICES Party/Vendor Contact Person: LYNELL HODGES
Contact Phone: 919-942-8741 x1482 Party/Vendor Address: PO BOX 17179 City CHAPEL HILL State: NC
Zip: 27516 Department: HEALTH Amount: $36.268 Purpose: REGISTERED DIETITIAN SERVICES Budget
Code(s): 10414005-443110-71411 Vendor#27898 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑
No® Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective Date 7/1/16 Approved by
Board Yes❑Nor-1 Agenda Date:
This agreement is approved as to to nt�R�I"Md cpntent:
7/6/2016
Department Director's Signature c9ED9DoFCSasasE_ Date:
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 rSx, �stand ards, specifications,and requirements:
Qr,Orwc,�16 7/6/2016
Office of the Risk Management Officer ,M, ,5�0049� 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 C� Date: 7/7/2016
1dF51 ginrr1anq
Legal Services
D c Signed by
This agreement is approved as t leg for and sufficiency:
av� 7/7/2016
Office of the County Attorney 4035CE3334CA4A9 Date:
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dollo��orangecount�
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 6/16
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