HomeMy WebLinkAboutR 2017-716-E Health - Health Ascent Associates consulting DocuSign Envelope ID:92EFA578-CE94-4EDA-BAE5-D7664F2BE88A
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Health Ascent Associates, LLC Party/Vendor Contact Person: Dr. Dorothy Cilenti Contact
Phone: 919-360-0039 Party/Vendor Address: 238 Trout Liles City Pittsboro State: NC Zip: 27312
Department: Health Amount: $8,700 Purpose: Provide support/coaching to new Health Director Budget Code(s):
10410020-630000 Vendor#64876 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract
Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 12-18-17 Approved by Board Yes❑
No❑ Agenda Date:
This agreement is approved as to to DocuSigned by: it:
�bV'b{�i Department Director's Signature Date:12/11/2017
5145A2CD945C40F...
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 -6ocuSigned by: rds, specifications,and requirements:
US66 �,bV1n.0 6 12/12/2017
Office of the Risk Management Officer[,7FDCF9176800498... 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 Officer 704E5181ACC1409. Date:12/12/2017
..
Legal Services
This agreement is approved as t oocusigned by:
§W.Ak t` $Lb 12/12/2017
Office of the County Attorney fl79A4D525C0F4FB... 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 10/17
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