HomeMy WebLinkAboutR 2016-678-E HR - Triangle J Council of Governments for drug, alcohol testing program DocuSign Envelope ID:21562812-A278-42AD-8638-D61555DD549A
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Triangle J Council of Governments Party/Vendor Contact Person: Judy Weller Contact Phone:
919-549-0551 Party/Vendor Address: 4307 Emperor Blvd, Suite 110 City Durham State: NC Zip: 27703
Department: Amount: $15,000.00 Purpose: Drug and Alcohol Testing Program Budget Code(s):
10295020/720033 Vendor# 5855 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract
Type: (Check one)New ❑ Renewal ® Amendment ❑ Effective Date Approved by Board Yes❑No®
Agenda Date:
This agreement is approved as to to bod content:
Department Director's Signature bayUhmt,w Date: 11/14/2016
81'C9862'6z3FU1%18F'..
i
u
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:
ii
Risk Management
This agreement is approved for sufficiency Z"77"bylandards,specifications, and requirements:
hvw ltb 11/28/2016
Office of the Risk Management Officer Date:
— eF�aseaoase--_.-
Financial Services
This instrument has been pre-audited' oraaa� uQquired by the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer � o Date: 11/30/2016
Legal Services
This agreement is approved as to le �o&g ,W,�,sufficiency,
Office of the County Attorney am Date: 11/30/2016
4035CB8304CA4A9...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydgworangecountyna.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 5