HomeMy WebLinkAboutR 2017-299-E Health - Melynee Falk for regional audiology consulting services DocuSign Envelope ID: 167F763C-D16E-41 D3-B98F-F5E24EE9CC37
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: $77,597 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 6/1/17 Approved by Board Yes No Agenda Date:
This agreement is approved as to tec n laid d content:
L6ttUl LLAAJt 7/12/2017
Department Director's Signature s,a5 2eD9a�eanF 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 t r _ staandards,specifications, and requirements:
MS& rbvvutl6 7/13/2017
Office of the Risk Management Office �,$6$gen� Date:
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act: DocuSigned by:
Crl ` n .A.x. 7/13/2017
Office of the Chief Financial Officer�oaes1a1accian9 Date:
Legal Services
This agreement is approved as t Ei4 tUrnV,i'd♦�-��sufficiency:
bUAL rv�OU'tL 1 S(6 7/13/2017
Office of the County Attorney Date:
079n1DS2SCOr4Fe...
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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