HomeMy WebLinkAboutR 2017-074 Health - UNC Health Care System for Komen Grant Breast Cancer Screening Services ORANGE COUNTY-DEPARTMENT USE ONLY 7 0,y�
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Party/Vendor Name: UNC Health Care System Party/Vendor Contact Person: Kathryn Grant Contact Phone:984-
974-1274 Party/Vendor Address: 211 Friday Center Drive City Chanel Hill State: NC Zip: 27517 Department:
Health Amount: $39,462 Purpose: Komen Grant Breast Cancer Screening- Services Budget Code(s): 30412005-
443057-71132 Vendor# 51843 Rem.6 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No®
Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 4/1/16 Approved by Board
Yes❑No❑ Agenda Date:
This agreement is approved as to technic a fo and content: `
Department Director's Signature "::, Date:.c
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 sufficiency of insurance�st/andards,specifications,and requirements:
Office of the Risk Management Officer__ A,— AV Date:
Financial Services
This instrument has been pre-audited in the m ere it d by e Local Government Budget and Fiscal Control
Act:
Office of the Chief Financial Officer. Date: Z S
Legal Services
This agreement is approved as to legal fo suffic y
Office of the County Attorney Date:
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon co letion @ Dollo}d((aoran eg countync.gov
The following signature block is for hard copies o is no equired for Docusign contracts:
Office of the Clerk to the Board Date:3
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