HomeMy WebLinkAboutR 2019-476 DSS - MediSolutions contract amendment DocuSign Envelope ID:3B617C6F-5AC0-46E6-B1CC-3E58D8A37545
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor 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:
$415,647/$75,000 Purpose: In-home aides services Budget Code(s): 10400220-630000/10400220-680026/10432020-
630100110432020-630105 Vendor# 65175 (NIA if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:
(Check one)New ❑ Renewal ❑ Amendment ® Effective Date May 20. 2019 Approved by Board Yes❑No❑ Agenda
Date:
This agreement is approved as to technical fonn and content and I as Department Director affirmatively state work on this project has
not been initiated prior to execution - Docusigned by:
�N �bS0_ 7/19/2019
Department Director's Signature oocusigned ay: Date:
��iu- - t�kr 7/19/2019
Department Director's Signature Date:
@7E962D1BF454=A..
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 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 Date:
Risk Management
This agreement is approved for sufficient ! cuSigned by: ' rds,specifications,and requirements:
Q�Sa �,DVIA.tr�b 7/1/2019
Office of the Risk Management t7ffice 7FDCF0176800408. Date;
Financial Services
This instrument has been pre-audited 'E7NE5181ACC1409
oocusigned by: the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officeq � Date:7/19/2019
.
Le al Services
This agreement is approved as t OocuSigned by: ncy:J'"ki_ 7/19/2019
Office of the County Attorney 4p35CB8304CA4M 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 12118