HomeMy WebLinkAboutR 2016-404-E Health - Wake Medical Laboratory Consultants, Inc. for lab services for Family Planning DocuSign Envelope ID: 155D1985-9FE0-4EA7-B67C-F2531BFF9621
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Wake Medical Laboratory Consultants, Inc. Party/Vendor Contact Person: Kerr Hughes
Contact Phone: 248-763-8504 Party/Vendor Address: 3000 New Bern Avenue City Raleigh State:NC Zip: 27610
Department: Health Amount: $15.000 Purpose: Lab Services for Family Planning Budget Code(s): 10414020-
632000-71406 Vendor# 63158 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract
Type: (Check one)New❑ Renewal ® Amendment ❑ Effective Date 7/1/16 Approved by Board Yes❑No
❑ Agenda Date:
This agreement is approved as to to el FIRffhy�id1Ac ntent:
Imo` 7/26/2016
Department Director's Signature -o,,,,-,,, Date:
Information Technolosies
(Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is
approved as to information technology content and specifications:
Office of the Chief Information Officer Date:
Risk Management
This agreement is approved for sufficiency Iiaswswoistandards, specifications,and requirements:
Qusa. r,Orwc,�16 7/26/2016
Office of the Risk Management Officer �,es,-s4z9,e04a8 Date:
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act: DocuSigned by:
7/27/2016
Office of the Chief Financial Officer 7o4ES1a1ACC1409... Date:
Legal Services
This agreement is approved as t eg$TIMIM sufficiency:
���1�- 7/27/2016
Office of the County Attorney 4035CE8304CA4A9 Date:
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 6/16
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