HomeMy WebLinkAboutR 2017-703-E Health - NRI service agreement DocuSign Envelope ID:CAABEAFA-9919-4207-B5CD-58E618EA747E
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: National Association of State Mental Health Program Directors Research Institute, Inc.
Party/Vendor Contact Person: Tim Knettler Contact Phone: 703-738-8160 Party/Vendor Address: 3141 Fairview
Park Drive, Suite 650 City Fall Church State: VA Zip: 22042 Department: Health Amount: $78,769 Purpose:
Conduct behavioral health system of care analysis. Budget Code(s): 10414020-630000 Vendor#N/A (N/A if new
vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑
Amendment ❑ Effective Date 11-15-17 Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to to DocuSigned by: nt:
,6rb{� 6W 11/15/2017
Department Director's Signature 5145A2CD945C40F... 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 sufficienc -oocuSlgned by: rds, specifications,and requirements:
Qusa, (��6 11/15/2017
Office of the Risk Management Officer 7FDCF9176900498... Date:
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act: DocuSigned by:
Office of the Chief Financial Office 7NE5181ACC1469. Date: 11/20/2017
..
Legal Services
This agreement is approved as t OocuSigned by: {�
9KIAk t, { 11/20/2017
Office of the County Attorney 079A4D525COF4F6... Date:
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd&oran eg countync. og_v
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board Date:
Revised 2/17 9