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2013-449 Health - Starpoint Global Service for Imaging Patient Records and Other Services $33,350
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2013-449 Health - Starpoint Global Service for Imaging Patient Records and Other Services $33,350
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11/13/2013 9:18:38 AM
Creation date
11/13/2013 8:46:16 AM
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BOCC
Date
11/12/2013
Meeting Type
Work Session
Document Type
Agreement
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Mgr Signed
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R 2013-449 Health - Starpoint Global Service for Imaging Patient Records and Other Services $33,350
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\Board of County Commissioners\Contracts and Agreements\Contract Routing Sheets\Routing Sheets\2013
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Exhibit C <br /> Authority For Access <br /> This shall be considered authorization for the following named individuals to have access to the contents held in the account of: <br /> Client Name: Client Account No. <br /> Department Sub Department <br /> Client Address: City: State: Zip Code: <br /> at Starpoint Global Services.These same individuals shall be considered having authority to order any and all disposition of the contents of this <br /> account by personal access,telephone,facsimile,email or written request until further written notice. <br /> ADD THE FOLLOWING: <br /> (Printed First Name) (Printed Last Name) (Optional Password,8 characters) (Signature) <br /> (Printed First Name) (Printed Last Name) (Optional Password,8 characters) (signature) <br /> (Printed First Name) (Printed Last Name) (Optional Password,8 characters) (Signature) <br /> 9 ) <br /> (Printed First Name) (Printed Last Name) (Optional Password,8 characters) (Signature) <br /> (Printed First Name) (Printed Last Name) (Optional Password,8 characters) (Signature) <br /> (Printed First Name) (Printed Last Name) (Optional Password,8 characters) (Signature) <br /> (Printed First Name) (Printed Last Name) (Optional Password,8 characters) (Signature) <br /> VOID THE FOLLOWING: <br /> (Printed First and Last Name) (Printed First and Last Name) <br /> (Printed First and Last Name) (Printed First and Last Name <br /> (Printed First and Last Name) (Printed First and Last Name <br /> (Printed First and Last Name) (Printed First and Last Name <br /> THIS AUTHORIZATION MUST BE SIGNED BY AN OFFICER OR AUTHORIZED MANAGER OF THE COMPANY <br /> (Print Name) (Signature) (Title) (Date) <br /> This document is confidential and contains the names of those individuals who are authorized to access any and all records stored at Starpoint Global Services.This information is intended <br /> only for the use of those individuals.Do not copy or distribute.To maintain security of your records please notify us immediately of any and all changes using this form.Changes become <br /> effective 24 hours after receipt of Original Copy.Fax and photocopies cannot be accepted.I mag <br /> 26 <br />
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