HomeMy WebLinkAboutR 2019-452 Health - Dixon Hughes Goodman cost study report DocuSign Envelope ID:C7EABF72-ADAA-4072-B58C-21B9B8A9AF97
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Dixon Huges Goodman,LLP Party/Vendor Contact Person: Kristi Chestnutt Contact Phone:
919-526-1824 Party/Vendor Address: 2501 B1ueRid,ge Road, Suite 500 City Raleigh State: NC Zip: 27607
Department: Health Amount: $5,500 Purpose: Prepare analysis of 2019 Cost Report Budget Code(s): 10410020-
630000 Vendor# 63893 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type:
(Check one) New ❑ Renewal ® Amendment ❑ Effective Date 7-1-19 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 by:
�utn AanA S&Wof 7/12/2019
Department Director's Signature sCisF2oosEsaa5F. 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 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-- -roocu5igned 6y:`---'-rds,specifications,and requirements:
U$66 (,bVln.t,{�6 7/15/2019
Office of the Risk Management Officer.[, Date:
7FDCF9178800498.
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act: DocuSigned by:
4 . 7/15/2019
Office of the Chief Financial Officer 1ACCAN. Date:
Legal Services
This agreement is approved as t DocuSigned by:
� x �- S� 7/15/2019
Office of the County Attorney 079A4D525C0F4FB. Date'
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:
Revised 12/18
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