HomeMy WebLinkAboutR 2017-342-E Health - Patricia L. Tolbert - Amendment to contract 2017-197-E 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