HomeMy WebLinkAboutR 2018-552 Health - Ockletree Morriss dental hygienist servicesRevised 10/17 5
ORANGE COUNTY—DEPARTMENT USE ONLY
______________________________________________________________________________
Department
Party/Vendor Name: Myesha Ockletree-Morriss, RDH Party/Vendor Contact Person: Myesha Ockletree-Morriss,
RDH Contact Phone: 919-475-8074 Party/Vendor Address: 3714 Ranbir Drive City Durham State: NC Zip: 27713
Department: Health Amount: $3,500 Purpose: Dental Hygienist Budget Code(s): 10410120-630000 Vendor # N/A
(N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal
Amendment Effective Date 1-16-18 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 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:_________
DocuSign Envelope ID: 7C9EE6E9-EC44-4535-8178-F11E04EBE677
1/12/2018
1/12/2018
1/12/2018
1/15/2018