HomeMy WebLinkAboutR 2017-515-E Health - NC Public Health Association for smoking cessation coaching DocuSign Envelope ID:4C3F4116-538F-4051-AC16-B880C7C5E276
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: North Carolina Public Health Association Party/Vendor Contact Person: Lynette Tolson Contact
Phone: 919-828-6201 Party/Vendor Address: 222 N. Person Street, Suite 208 City Raleigh State: NC Zip: 27601
Department: Health Amount: $5,000 Purpose: Smoking cessation coaching Budget Code(s): 10412020-680070-71454
Vendor# 50866 (N/A if new vendor) Vendor is a BOCC consultant'? Yes ❑ No Contract Type: (Check one)
New ® Renewal ❑ Amendment ❑ Effective Date 10-4-17 Approved by Board Yes No Agenda Date:
This agreement is approved as to tectin 1�f�id d��c�on1n�tent:
bro 1,.u1Tt 9/13/2017
Department Director's Signature —5145A2cO 45c49F 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 Eittalsratuseystandards, specifications, and requirements:
aMtSA. rbvvutl6 9/13/2017
Office of the Risk Management Officer
-T 9498 Date:
Financial Services
This instrument has been pre-audited i t eD i P P quired by the Local Government Budget and Fiscal Control Act:
�°" .0°"D 9/13/2017
Office of the Chief Financial Officer 7D4E5181ACC1409... Date:
Legal Services
This agreement is approved as tr, '-... Oitivicidavid sufficiency:
I AA. hark- 1 sc.b 9/13/2017
Office of the County Attorney Date:
o € DSZSeararc.._
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 5