HomeMy WebLinkAboutR 2018-121 Emergency Svc - UNC medical director contract7
Rev. 6/17
ORANGE COUNTY—DEPARTMENT USE ONLY
________________________________________________________________________
Department
Party/Vendor Name: University of North Carolina Party/Vendor Contact Person: Greg Godic Contact
Phone: 919-843-9480 Party/Vendor Address: UNC School of Medicine
3140 Bioinformatics Building
City Chapel Hill, State: NC Zip: 27599 Department: Emergency Medicine Amount: $51,700 Purpose:
Budget Code(s): 10-757520630000 Vendor # (N/A if new vendor) Vendor is a BOCC
consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective
Date Approved by Board Yes No Agenda Date:
This agreement is approved as to technical form and content:
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 sufficiency of insurance standards, specifications, and requirements:
Office of the Risk Management Officer___________________________________ Date: _________
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal
Control Act:
Office of the Chief Financial Officer ____________________________________ Date: _________
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney __________________________________________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:
DocuSign Envelope ID: 0420C055-135C-4A55-9126-6985B56EAC9C