HomeMy WebLinkAboutR 2017-638-E Health - Health Ascent Associates, LLC to provide Interim Health Director services DocuSign Envelope ID:CDCEC775-C81E-44AD-AB72-5C4ADF26C195
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Health Ascent Associates, LLC Party/Vendor Contact Person: Dr. Dorothy Cilenti Contact
Phone: 919-360-0039 Party/Vendor Address: 238 Trout Lily Lane City Pittsoboro State: NC Zip: 27312
Department: Health Amount: $6,300 Purpose: Provide Interim Health Director Services Budget Code(s):
10410020-630000 Vendor#64876 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract
Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 11-22-17 Approved by Board Yes
No Agenda Date:
This agreement is approved as to to .c l ltd content:
Department Director's Signature Date: 11/22/2017
050C5E2C74804E9...
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 -utzetanneaystandards,specifications, and requirements:
MS& CbYliuth 11/22/2017
Office of the Risk Management Officer 7PDsRs4z680e49a Date:
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act: DocuSigned by:
Office of the Chief Financial Officer ��� Date: 11/22/2017
7D4E5181ACC1409...
Legal Services
This agreement is approved as tr, -;y1c06MfidNid sufficiency:
/
tAAAA. SCb 11/22/2017
Office of the County Attorney t179�mix25C-er4n3... 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 10/17
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