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HomeMy WebLinkAbout2017-342-E Health - Patricia L. Tolbert - Amendment to contract 2017-197-E DocuSign Envelope ID:BCE64A7F-AC28-4B03-BFA7-B9965384DA09 ORANGE COUNTY AMENDMENT TO SERVICES AGREEMENT NORTH CAROLINA THIS AMENDMENT, made and entered into this the eighteenth day of July, 2017, by and between the County of Orange, a body politic and corporate of the State of North Carolina, ("County"), and Patricia Lynn Tolbert ("Provider"); WITNESSETH: WHEREAS, the County and Provider entered into a Services Agreement dated, May 22, 2017, to provide services to be rendered by Provider to County's Health Department("Original Agreement"); and WHEREAS, the County and Provider desire to amend the Original Agreement, while keeping in effect all terms and conditions of the Original Agreement not inconsistent with the terms and conditions set forth below. NOW THEREFORE, for and in consideration for the mutual covenants and agreements made herein, the parties agree to amend the Original Agreement as follows: The term of this Agreement rendered shall be from May 22, 2017 through September 15,2017. Except for the changes made to the Services and term of the contract , the Original Agreement shall remain in full force and effect to the extent it is not inconsistent with this Amendment. In the event that there is a conflict between the Original Agreement and this Amendment,this Amendment shall control. IN WITNESS WHEREOF, Orange County and the Consultant have signed this Amendment, effective this the 18t''day of July, 2017. FO t. it*IKGR:COUNTY eOR,PROVIDER: bbtn,ltiit, t'awtwtt,lrSt Padua (, UbtAL By: --- 0637994B755E477... By: 79p038.EB4 Fan7G County Manager Patricia Lynn Tolbert Revised July 2015 DocuSign Envelope ID:BCE64A7F-AC28-4B03-BFA7-B9965384DA09 ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Patricia L. Tolbert .Party/Vendor Contact Person: Trish Tolbert Contact Phone: 336-524-4505 Party/Vendor Address: 2900 Shagbark Lane City Graham State: NC Zip: 27253 Department: HEALTH Amount: Purpose: Development coaching—Amendment to contract#2017-197-E Budget Code(s): 10412020-630000-71453 Vendor# 64504 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No Contract Type: (Check one)New ❑ Renewal ❑ Amendment ® Effective Date 5/22/17 Approved by Board Yes No Agenda Date: This agreement is approved as to tec . Eltl / d content: a,„-- 7/20/2017 Department Director's Signature 5145n2GD945C40F 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 ma" _b''standards,specifications, and requirements: ausi 7/24/2017 Office of the Risk Management Officer 7FDCF9176800498... Date: Financial Services This instrument has been pre-audited i ��1 itquired by the Local Government Budget and Fiscal Control Act: elotri s�o .� 7/24/2017 Office of the Chief Financial Officer4E5181ACC140g... Date: Legal Services This agreement is approved as to eg iN1fda�1d Buff ciency: µ L -Sca 7/25/2017 Office of the County Attorney fl7QA D525C E4FB 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 July 2015 DocuSign Envelope ID:BCE64A7F-AC28-4B03-BFA7-B9965384DA09 Kimberlee Quatrone From: Dorothy Cilenti Sent: Tuesday, May 16, 2017 10:54 PM To: Coby Austin Cc: Rebecca Crawford; Donna King; Meredith McMonigle; Kimberlee Quatrone Subject: RE: REQUEST: insurance waiver-Trish Tolbert ok I approve From: Coby Austin Sent: Tuesday, May 16, 2017 9:01 PM To: Dorothy Cilenti Cc: Rebecca Crawford; Donna King; Meredith McMonigle; Kimberlee Quatrone Subject: RE: REQUEST: insurance waiver-Trish Tolbert Nope. I just need you to say yes by email. I have a record of your recent response for another consultant, but 1 didn't see it for this one yet.Thanks! Coby Jansen Austin, MPH Director of Programs and Policy Family Success Alliance&Board of Health Phone:919-245-2070/Fax:919-245-0896 Improvirtg health. Inspiring change. ge. CONFIDENTIALITY NOTICE: All email messages, including any attachments, generated from or received by this site are the property of Orange County Government and are considered public domain subject to the North Carolina Public Record Law.The Orange County Health Department transmits minimal confidential client/patient information via email, and any unauthorized review, use,disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message. If you believe there has been an inappropriate disclosure, please contact Carla Julian, OCHD HIPAA Privacy and Security Officer, at ciulianorandecountvnc.gov. From: Dorothy Cilenti Sent: Tuesday, May 16, 2017 7:28 PM To: Coby Austin Cc: Rebecca Crawford; Donna King; Meredith McMonigle; Kimberlee Quatrone Subject: RE: REQUEST: insurance waiver-Trish Tolbert Is there something you need for me to sign electronically? I think I gave approval via email. thanks . .. ....... From: Coby Austin Sent: Tuesday, May 16, 2017 11:58 AM 1 DocuSign Envelope ID:BCE64A7F-AC28-4B03-BFA7-B9965384DA09 To: Dorothy Cilenti Cc: Rebecca Crawford; Donna King; Meredith McMonigle; Kimberlee Quatrone Subject: REQUEST: insurance waiver-Trish Tolbert Hi Dorothy, Ms. Tolbert is not an LLC and will be contracting with us as an individual. Can you please approve a waiver of the insurance requirement stipulated in the county contract template? Thanks! Coby Coby Jansen Austin, MPH Director of Programs and Policy Family Success Alliance& Board of Health Phone:919-245-2070/Fax:919-245-0896 improvg heckrh- in$0;ring Con re. You _. CONFIDENTIALITY NOTICE: All email messages, including any attachments, generated from or received by this site are the property of Orange County Government and are considered public domain subject to the North Carolina Public Record Law.The Orange County Health Department transmits minimal confidential client/patient information via email, and any unauthorized review, use,disclosure or distribution is prohibited. If you are not the intended recipient, please contact the sender by reply email and destroy all copies of the original message. If you believe there has been an inappropriate disclosure, please contact Carla Julian, OCHD HIPAA Privacy and Security Officer, at cju]ian©orangecountync.gov. From: Coby Austin Sent: Thursday, May 11, 2017 8:49 AM To: Kimberlee Quatrone; Dorothy Cilenti Cc: Rebecca Crawford; Donna King; Meredith McMonigle Subject: Contract request &insurance waiver-Trish Tolbert Hi Kim - Please see attached for the contract request for working with Trish Tolbert on development/fundraising technical assistance for Family Success Alliance. She feels more comfortable dropping off a hard copy of her W9, rather than sending it by email, since it includes her SSN. I copied you on an email to her with directions to your office, since I am offsite much of today and tomorrow. I'm including her resume not as part of the contract, but in case the county manager or anybody wants to see it. Dorothy—Ms.Tolbert is not an LLC and will be contracting with us as an individual. Can you please approve a waiver of the insurance requirement stipulated in the county contract template? Rebecca/Donna/Meredith—Just keeping you in the loop that I'm putting in this request. Coby 2