HomeMy WebLinkAboutR 2019-643 Health - Patagonia Health software amendment DocuSign Envelope ID:881484B7-44A8-4DD9-9947-6209CB23CD79
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Patagonia Party/Vendor Contact Person: Amos Slate Contact Phone: 919-439-0964
Party/Vendor Address: 15100 Weston Parkway#204 City CM State: NC Zip: 27513 Department: Health
Amount: $22,155 Purpose: Extend existing contract on month-by-month basis for Pharmacy app and full data
extraction. Budget Code(s): 10414020-630000 & 61370035-800100-30012 Vendor# 61583 (N/A if new vendor)
Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New ❑ Renewal ❑ Amendment
Effective Date 10-1-19 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:
6iK na ' S&W 9/9/2019
Department Director's Signature Date:
3C16F2D09E3445F.
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 co DocuSigned by:- ons:
Office of the Chief Information Officer ,�tm 4"y C116A91E73A64DF.. Date: 9/16/2019
Risk Management
This agreement is approved for sufficient -oocuSigned by: rds,specifications,and requirements:
USX �,bV1n.t,{�6 9/16/2019
Office of the Risk Management Officer 7FDCF9170800L98. Date:
Financial Services
This instrument has been pre-audited i Docusigned by: the Local Government Budget and Fiscal Control Act:
9/17/2019
Office of the Chief Financial Office 7NE5181ACC1409. Date:
Legal Services
This agreement is approved as tcg x D"USigned by:
�S(h
Office of the County Attorney Date: 9/18/2019
079A4D525C0F4FB.
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