HomeMy WebLinkAboutR 2018-305 Health - Robert Dupuis pharmacy servicesRevised 7/18
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ORANGE COUNTY—DEPARTMENT USE ONLY
______________________________________________________________________________
Department
Party/Vendor Name: ROBERT DUPUIS Party/Vendor Contact Person: ROBERT DUPUIS Contact Phone: 919-966-
4131 Party/Vendor Address: 205 KENILWORTH PLACE City CHAPEL HILL State: NC Zip: 27516 Department:
HEALTH Amount: $12,645 Purpose: PHARMACY SERVICES Budget Code(s): 10414020-630000 Vendor # 47361
(N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal
Amendment Effective Date 7/1/2018 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: F6A443CE-4CB1-4DE4-AA82-616F9B13A0C0