R 2013-449 Health - StarPoint Global Service for Imaging Patient Records and other Services $33,350

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ORANGE COUNTY-CONTRACT CONTROL SHEET Routing Order: (1)Department,(2)IT,(3)Risk Management,(4)Financial Services,(5)Attorney,(6)Manager,(7)Clerk This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. If the Manager determines the contract is not appropriate for Manager approval the Manager shall submit the contract for BOCC approval. Contracts for BOCC approval must be submitted through, and complete,the routing process prior to agenda review. Contracts for legal review should be completed through the legal review process prior to being routed for signature. Department Party/Vendor Name: Starpoint global Service Party/Vendor Contact Person: Richard Rav Contact Phone:919-933-9529 Party/Vendor Address: 1 Ashley Wade Lane City Chapel Hill State:NC Zip:27516 Department:Public Health Amount:$33,350 Purpose:Imag_irl Patient Records and Other Servicesas provided in Estimated Cost and Service Proposal Budget Code(s):61-3700-35-800100-30012 Vendor#690039 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date October 21,2013 Approved by Board Yes❑No❑ Agenda Date: Title of Contract: Business Associate Agreement If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners Yes❑No❑. If submitted for bid were bids/RFPs received Yes❑No❑ Bid/RFP number This contract has been reviewed and approved by the Department Director as to technical content: Department Director's Signature: Date: IT Director (Applicable only to hardware/software purchases or related services)This contract has been reviewed and approved by the Information Technology Director as to technical content and information technology specifications: IT Director's Signature: Date: Risk Management Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required ❑. Hold Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shown,this contract is approved by the Risk Manager: Risk Manager's Signature: _ " Date: /16 Z Financial Services This Contract is conditioned on appropriation by the Board of Commissioners Yes❑Now A budget amendment is necessary before approval Yes❑No[Z.If budget amendment is necessary,please attach to this form. This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Financial Services Director's Signature: � � �� Date: 1.3 lo1z:8 County Attorney Approval by Board ❑ (Contracts $90,00 0 or more for goods or services, $250,000.00 or more for construction, or any BOCC consultant contract). Approval by M agerX(Most other contracts$1,000 and above). Department Director approval only❑ (Under $1,000). This contract has be i d d approved by the Attorney as to legal form and suffici ncy: Attorney's Signature Date: 1 1 j County Manager This contract has been reviewed and is a pro by the County Manager YesK'&o❑. This contract has been reviewe is r s' at ur the it Y No❑. Manager's Signature: Date: Clerk to the Board Approved by BOCC on the_day of 20 Subm' r hair a 01,the day of 120 Clerk's Signature: Date: [ Revised March 2012