HomeMy WebLinkAboutR 2016-396-E Health - Freedom House to provide Zone 4 Navigator Services DocuSign Envelope ID:F6D4D28D-1 E29-4905-AB38-673A41 131371`34
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Freedom House Party/Vendor Contact Person: Patricia Hussey Contact Phone: 919-942-8083
Party/Vendor Address: 104 New Stateside Drive City Chapel Hill State: NC Zip: 27516 Department: Health
Amount: $57,893 Purpose: Provide Zone 4 Navigator Services Budget Code(s): 10414020-681000-71453 Vendor#
34104 (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 n c°3F`Y�ff hfid c ntent:
� � 7/11/2016
Department Director's Signature G Fa 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 sufficienc 4 t �_�ys'taandards,specifications,and requirements:
aLtSA rbvvutl6 7/11/2016
Office of the Risk Management Officer. Ga17raoo4aa Date:
Financial Services
This instrument has been pre-audited iWtfxPmWPm#"quired by the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer Date: 7/22/2016
Legal Services
This agreement is approved as t e a� o in Ad sufficiency:
� -�4� 7/22/2016
Office of the County Attorney 4o35ce83o4cA4AS... Date:
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd&oran eg countync.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:
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