HomeMy WebLinkAboutR 2019-371 Emergency Svc - UNC Medicine Medical Director services DocuSign Envelope ID:C147995A-34FD-4913-8C66-E8A65CCEA168
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: University of North Carolina- School of Medicine Party/Vendor Contact Person:
Alison M. Melvin Contact Phone: 919-966-4548 Party/Vendor Address: 3140 Bioinformatics Building
City Chapel Hill State: NC Zip: 27599 Department: Office of Professional Service Contracts and
Affiliations Amount: 51,700 Purpose: EMS Medical Director's Contract Budget Code(s): 10-
7575206300 Vendor # N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No®
Contract Type: (Check one)New❑ Renewal® Amendment ❑ Effective Date 07-01-2019 Approved
by Board Yes❑No® Agenda Date:
This agreement is approved as to technical form and content and I as Department Director affirmatively
state work on this project has not been initiated prior to execution of the agreement:
DocuSigned 6y:
�{ 6/21/2019
Department Director's Signature Date:
5655BC89iAS4473.
Agreements for emergency services or repair are not subject to the above affirmation. If services related to
this agreement have already begun or been completed please briefly describe the nature of the emergency
condition that was addressed:
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 sufficienr--oocusigned by:-`---",trds,specifications,and requirements:
Office of the Risk Management OfficeaCisa �a Date.6/22/2019
7FDCF9176900498.
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 A .&I. Date:6/21/2019
704E5181ACC1409.
Legal Services
This agreement is approved as DocuSigned by: =y:
Office of the County AttorneL-4035CB8'304C'
Date:6/24/2019
A4A�
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:
7