HomeMy WebLinkAboutR 2018-284 CJRD - UNC School of Medicine services agreement0
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ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: UNC School of Medicine - Department of Psychiatry Party/Vendor Contact Person: Karlina
Matthews, Associate Chair for Administration Contact Phone: 919 -960 -1291 Party/Vendor Address: 378 Medical /
School Wing D, CB# 7160 City Chapel Hill State: NC Zip: 27599 -7160 Depa nt: CJRD Amount: $25,000 V
Purpose: contract psychiatry Budget Code(s): 10212020-630000 (PO 1802270 -0 dor # 49882 (N /A if newq I ('3119
vendor) Vendor is a BOCC consultant? Yes ❑ NoN Contract Type: (Che one) New N Renewal ❑
Amendment ❑ Effective Date 6/10/18 Approved by Board Yes❑ No❑ Agenda Date:
This agreement is approved as to technical form and content:
Department Director's Signature Date: 7 & ty'
Information Technologies
(Applicable only to hardware /sgfhvare 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.
Risk Management
Date:
This agreement is approved for sufficiency of insurance standards, specifications, and requirements:
Office of the Risk Management Officer, Date: 1
This instrument has been pre - audited
Act:
Office of the Chief Financial Officer
Legal Services
This agreement is approved as to legal form and sufficiency:
ment Budget and Fiscal Control
Date: / IL 9
Office of the County Attorney Date: 4 /�
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll oran ecountync,gov
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Cleric to the Board Date:
Revised 10/17