HomeMy WebLinkAboutR 2018-693 Health - UNC Health System tubal ligation services A010 r3
ORANGE COUNTY--DEPARTMENT USE ONLY-HARD COPY ONLY
Department
PartyNendor Name: UNC Health Care System PartyNendor Contact Person: Kathryn Grant Contact Phone: 984-
974-1274 PmtyNendor Address: 211 Friday Center Drive City Chanel Hill State: NC Zip: 27517 Deparmrem:
J ealdi Amount $30,000 Purpose: Perform tribal ligation for uninsured women Budget Code(s): 10414020-
0000-71400 Vendor # 30892 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract
F (Check one) New E] Renewal ® Amendment ❑ Effective Date 7-1-18 Approved by Board Yes❑ No
❑ Agenda Date:
This agreement is approved as to tec ' al form and content: µ
Department Director's Signature��t Date: /LI //a
Information Technologies
(Applicable only to hardwaralsofeaare 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 Risk Management ax _ (,�0�n, �.�Date: —zi/z.k1(j>
Financial Serv'
This instrument has been pre-audited in the4mer tred y the Local Government Budget and Fiscal Control
Act:
Office of the Chief Financial Officer Date: D /8
Legal Services
This agreement is approved as to legal form and sufficiency::
Office of the County Attorney (/'hu L (a,: /K 6'-' Date: 1 y I30/ Ik
Clerk to the Board
Received for record retention:
Office of the Clerk to the Board Date:
Revised 10/17