HomeMy WebLinkAboutR 2016-542-E Health - Dixon Hughes Goodman, LLP to prepare analysis of 2016 Cost Report DocuSign Envelope ID: 1 EF49E613-1 EFO-47A4-BA6D-5E74D5138GF9
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 Raleigh State: NC Zip: 27607
Department: Health Amount: $6,200 Purpose: Prepare analysis of 2016 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 9/23/16 Approved by Board Yes❑ No❑ Agenda
Date:
This agreement is approved as to to ni8atuRAi`l44'%d content:
��_ 9/27/2016
Department Director's Signature €oaslaG-o�sa� 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 6(i Ys'tandards, specifications, and requirements:
AUSa. (hnutl6 9/27/2016
Office of the Risk Management Officer Date:
Financial Services
DocuSi ned b
This instrument has been pre-audited i the manner by: by the Local Government Budget and Fiscal Control Act:
� p 9/27/2016
Office of the Chief Financial Officer M4E5181ACC14o9... Date:
Legal Services
This agreement is approved as to Ee7g9f T6 ?ReAllU sufficiency:
�i V-_ 9/28/2016
Office of the County Attorney 4os5cea1o4cA4A9 Date:
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dollo d&oran etync. oovv
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