R 2014-573 HR - Job Ready Services, LLC for the WorkSTEPS Testing Program for Workplace Fitness For Duty and Functional Capacity Testing for Certain Work Groups $15,000

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DocuSign Envelope ID: Al E64657- B4BC- 4CBD- BBDE- 98475BE11255 E DS YT ORANGE COUNTY — DEPARTMENT USE ONLY Department Party/Vendor Name: Job Ready Services Party/Vendor Contact Person: Debra Lord Contact Phone: 919 - 256 -1400 Party /Vendor Address: 2300 Westinghouse Blvd, Suite 107 City Raleigh State: NC Zip: 27604 Department: Amount: $15,000 Purpose: Workplace Fitness For Duty and Functional Capacity Testing For Certain Work Groins Budget Code(s): 10250020/630000 Vendor # 62027 (N /A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective Date September 1, 2014 Approved by Board Yes❑ No® Agenda Date: This agreement is approved as to tec cRiT5' law'ii,cooAt/e�nt: 12/2/2014 Department Director's Signature ,,,8l2rc)F014RF Date: 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 Risk Management Date: This agreement is approved for sufficiencCA h%stoa standards, specifications, and requirements: US& r,6vvt,e b 12/2/2014 Office of the Risk Management Officer zE Date: Financial Services This instrument has been pre - audited in a fl nt Budget and Fiscal Control Act: � tiizti Office of the Chief Financial Officer Date: 12/2/2014 E982FraaCNu4ad Legal Services This agreement is approved as to sufficiency: [ 4"id Office of the County Attorney1 Date: 12/4/2014 Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydgorangecountync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board Revised 10/14 4 Date: