HomeMy WebLinkAboutR 2016-481-E DSS - Chatham Transit Network for non-emergency Medicaid transportation DocuSign Envelope ID:BD69DF46-15CD-49E6-8588-93617FCCFB94 Contract#68-2030
Chatham Transit Network
ORANGE COUNTY-DEPARTMENT USE ONLY
Departmen
Party/Vendor Name: Chatham Transit—Netwollk Party/Vendor Contact Persom A—nnaTesterman. Contact Phone: ftl954_2-5136
PartyNendor Address:EQ Box 103Z City Ektt—sboro State:NC Zip:27312 Department:Social Services Amount:$10 000 Purpose:Non-
:L[qjjWgqation Budget Code(s): Vendor# (N/A if new vendor) NoZ
Contract Type: (Check one)New E] Renewal E Amendment F
1�2O 16 Approved by Board Yesf
Agenda Dute: ____
This agreement is approved as to technical form a L,
Date: 8/23/2016
D4m� e�Dio�or°mSi�u�� � _____
Information Technologic
(Applicable only to hardwarelsoj�ware 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 Uate:_______
Risk Manaaeme
This agreement io approved for sufficiency of insuranc ations, and roquirnmonUy:
8/22/2Olh
Date:
Office of the Risk Management<�U@co . __...
_____
Financial Services
This instrument has been pre-audited ot Budget and Fiscal Control Act:
8/Z3/ZOl6
��#iceuf the��bic{Financial<�t�cer D�r�________
Legal Services
This agreement io approved fd
Date:8/23/2016
��yOocuf the�County Attorney �_______
Clerk to the Board
Received for record retention:
All Douuaigu contracts must 6c copied to Donna Lloyd upon completion 1@)
The following signature block is for hard copies only and is not required for Docusign contracts:
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@�Oucof the K�|erktothe Board Da�.________
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Contract-General (07/10) Page 5of5
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