HomeMy WebLinkAboutR 2017-152-E Health - Melynee Falk for regional audiology consulting services DocuSign Envelope ID:8F46C2BA-AC7A-464D-B01A-1E2581B55465
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Melynee Falk Party/Vendor Contact Person: Meylnee Falk Contact Phone: 336-402-1025
Party/Vendor Address: 803 Seven Oaks Drive City Greensoboro State: NC Zip: 27410 Department: Health
Amount: $15,000 Purpose: Regional audiology consulting services Budget Code(s): 10414020-630000 Vendor#
64366 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ❑
Renewal❑ Amendment ❑ Effective Date 4/1/17 Approved by Board Yes No Agenda Date:
LXOttU1 D b This agreement is approved as to to cf m nd d co tent:
l 3/30/2017
Department Director's Signature 5145A2CD945C40F... 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 sufficient 4amliVit48_eys'tandards,specifications, and requirements:
aMiS& rbvvutl6 3/31/2017
Office of the Risk Management Officer 7FDCF9176800498... Date:
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
DocuSigned by:
Act:
` "' .A.x. 5/5/2017
Office of the Chief Financial Officer C(71.4.,
7D4E5181ACC1409... Date:
Legal Services
D c igned by:
This agreement is approved as t 1 a� or lan�dd suf ciency:
'1' '1' ISO 5/5/2017
Office of the County Attorney 079A4D525C0F4FB... Date:
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd @orangecountync.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 2/17
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