HomeMy WebLinkAboutR 2017-122 Aging - UNC Hospitals for Wellness Program Coordinator ORANGE COUNTY---DEPARTMENT USE ONLY---HARD COPY ONLYa
Department
Party/Vendor Name: UNC Hospitals Party/Vendor Contact Person: Susan Blalock Contact Phone:
Party/Vendor Address: 211 Friday Center Dr., Ste. G021 City Chapel Hill State: NC Zip: 27517 Department:
Aging Amount: $25,000 Purpose: Wellness Program Coordinator Budget Code( • 7Check Vendor# � '
30892 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No[—] Con pe: )NewRenewal ® Amendment ❑ Effective Date 07/01/2016 Approved by Board Yes Nonda Date:
This agreement is approved as to technical form and content: 6 6�
Department Director's Signature Date: j-A-/7 ' I
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 standards,specifications,and requirements:
1 _
Office of Risk Management 1it`6 - t Q Date:_ t
F'nan ' rvice
This instrument has been pre-audited in the er quir d b t e Local Government Budget and Fiscal Control
Act: /
Office of the Chief Financial Officer Date:
Legal Services
This agreement is approved as to legal form and sufficiency: /
Office of the County Attorney (/{(�il,� (/ �� 6th Date: `t 1 cl I�l
r
Clerk Ohe B and
Received for record retention:
Office of the Clerk to the Board Date:
Revised 2/17