HomeMy WebLinkAboutR 2018-296 Health - Melynee Falk audiology servicesRevised 10/17
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ORANGE COUNTY—DEPARTMENT USE ONLY
______________________________________________________________________________
Department
Party/Vendor Name: Melynee Falk Party/Vendor Contact Person: Meylnee Falk Contact Phone: 336-402-1025
Party/Vendor Address: 803 Seven Oaks Drive City Greensboro State: NC Zip: 27410 Department: Health
Amount: $77,597 Purpose: Regional audiology consulting services Budget Code(s): 10414020-630000-71423
Vendor # 64366 (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one)
New Renewal Amendment Effective Date 6-1-18 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 Sherri Ingersoll upon completion: singersoll@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:_________
DocuSign Envelope ID: BB4B5E63-95D6-479B-914C-72E3500C9FAC
7/17/2018
7/19/2018
7/19/2018
7/20/2018