HomeMy WebLinkAboutR 2019-425 DSS - Medisolutions Nursing in home care DocuSign Envelope ID: 19BCEAA9-F982-42A7-972B-A7E79E20FF66
ORANGE COUNTY-DEPARTMENT USE ONLY
PartyNendor Name: MediSolutions Inc. Party/Vendor Contact Person: Robin Creason Contact Phone: 336-329-
9060 Party/Vendor Address: 100 N. Church St. Suite B. City Burlington State: NC Zip: 27217 Department:
Social Services Amount: $10,000 Purpose: RN Services Budget Code(s): 10406220-622000 Vendor # 65175
(N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ❑
Renewal ® Amendment ❑ Effective Date July 1, 2019 Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to technical forth and content and I as Department Director affirmatively state work
on this project has not been initiated prior to execution of the agreement:
DocuSigned by:
N �b5l+btn 7/8/2019
Department Director's Signature DAE1E198A83B455 Date:
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 Technolozies
(Applicable only to hardwarelsoftware 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 hate:
Risk Management
This agreement is approved for suffiicienc DocuSigned by: ids,specifications,and requirements:
Office of the Risk Management Officellusa L.Q�6 7FDC F91 7e800498. �'' 7/3/2019
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act: DocuSigned by:
lr7NE5181ACC1409.
4 � � 7/8/2019
Office of the Chief Financial Officer Date:
Legal Services
This agreement is approved as to DocuSigned by: -- icy:
Office of the County Attorney -" �` '°y' - Date:7/9/2019
4035CB8304CA4M
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Sherri Ingersoll upon completion: snngersoll@orangecountync.gov
The following signature block is for bard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board Date:
Revised 12/18
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