HomeMy WebLinkAboutR 2019-841 Health - Durham County health dept lab servicesRevised 6/19
8
ORANGE COUNTY—DEPARTMENT USE ONLY
______________________________________________________________________________
Department
Party/Vendor Name: Durham County Department of Public Health Party/Vendor Contact Person: Katie Mallette
Contact Phone: 919-560-7692 Party/Vendor Address: 414 East Main Street City Durham State: NC Zip: 27701
Department: Health Amount: $36,000 Purpose: Analyze specimens and report findings Budget Code(s):
10414020-632000-71416 Vendor # 35482 (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:
Department Director’s Signature ________________________________________ 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: This vendor performs labs for our STD patients. We were unable to get the COI in a timely fashion,
but couldn't allow labs not to be done. We just received it allowing the contract to be routed.
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 sufficiency of insurance standards, specifications, and requirements:
Office of the Risk Management Officer___________________________________ Date: _________
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act:
Office of the Chief Financial Officer ____________________________________ Date: _________
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney __________________________________________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:_________
DocuSign Envelope ID: 4FE28997-8839-4B4D-BA87-1A027F8E5CED