HomeMy WebLinkAboutR 2017-511-E Health - Piedmont Health Services for registered dietitian services DocuSign Envelope ID:47469A1E-8025-4EFO-BOCD-3986AFAB0354
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: PIEDMONT HEALTH SERVICES Party/Vendor Contact Person: ASHLEY BREWER
Contact Phone: 336-382-0242 Party/Vendor Address: 127 KINGSTON DRIVE City CHAPEL HILL State: NC
Zip: 27514 Department: HEALTH Amount: $34,533.50 Purpose: REGISTERED DIETITIAN SERVICES
Budget Code(s): 10414005-443110-71411 Vendor#27898 (N/A if new vendor) Vendor is a BOCC consultant?
Yes ❑ No Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective Date 7/1/17
Approved by Board Yes No Agenda Date:
This agreement is approved as to to IV fi co tent:
Vat 9/8/2017
Department Director's Signature .., „ Date:
Information Technologies
(Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is
approved as to information technology content and specifications:
Office of the Chief Information Officer Date:
Risk Management
This agreement is approved for sufficient i:inswannuerstandards,specifications, and requirements:
IU Sa C,bV ktffb 9/8/2017
Office of the Risk Management Office 7FDCE9176800498... Date:
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act: DocuSigned by:
` °" '"°"` 9/8/2017
Office of the Chief Financial Officer C(71.4.,
7D4E5181ACC1409... Date:
Legal Services
This agreement is approved as t e 971:$Yid sufficiency:
AL �ArtL �SG6 9/8/2017
Office of the County Attorney 079A1D525CBF4Fe... 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 7/17
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