HomeMy WebLinkAboutR 2016-342-E Health - Dixon Hughes Goodman, LLP to prepare analysis of 2014 Cost Report DocuSign Envelope ID:63B49CO3-DB46-4935-A8E4-1E08211FDE8D
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Dixon Huges Goodman, LLP Party/Vendor Contact Person: Kristi Chestnutt Contact Phone:
919-526-1824 Party/Vendor Address: 2501 B1ueRidge Road, Suite 500 City Ralei State: NC Zip: 27607
Department: Health Amount: $2,000 Purpose: Prepare analysis of 2014 Cost Report Budget Code(s): 10410020-
630000 Vendor#63893 (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❑ No❑ Agenda
Date:
This agreement is approved as to to and content:
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Department Director's Signature Date: 6/30/2016
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 sufficient g , g„standards, specifications,and requirements:
Q ,SX r,Orin,c,�16 6/30/2016
Office of the Risk Management Office Date:
Financial Services
This instrument has been pre-audited i e°iffiftWVTV p�quired by the Local Government Budget and Fiscal Control Act:
ita
Office of the Chief Financial Officer4a,A ,4os Date: 7/8/2016
Legal Services
This agreement is approved as t egRTCr18Rff''�d sufficiency:
Office of the County Attorney Date: 7/8/2016
�,1 3' 4035CB83D4CA4A9...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloy(d c�orangecount.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 5