R 2015-141-E Co. Mgr. - UnitedHealthCare of NC - Amendment to Excess Loss Insurance Policy

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i DocuSign Envelope ID: 7DB9202D-FDA8-426E-8A84-EAE7538E9310 ORANGE COUNTY-DEPARTMENT USE ONLY ti Department Party/Vendor Name: UnitedHealthcare of NC Party/Vendor Contact Person: Patricia Martin Contact Phone: 919- 840-3106 Party/Vendor Address: 3131 RDU Center Drive City Morrisville State: NC Zip: 27560 Department: Amount: $635,758.00 Purpose: UnitedHealthcare Excess Loss Insurance Policy Amendment Budget Code(s): Vendor#47140 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New❑ Renewal ❑ Amendment M Effective Date 1/1/2015 Approved by Board Yes® No❑ Agenda Date: 9/17/2013 This agreement is approved as to t Bali f „and content: Department Director's Signatu Date: 2/19/2015 B 1C98D269F0148F... i i 1 Information Technologies r (Applicable only to hardware/software patrchases 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: i G Risk Management This agreement is approved for sufficiency of i3§A%WP1*andards,specifications,and requirements: k r usa, (hm,&6 Office of the Risk Management Officer Date: 2/20/2015 7FDCF917680049& Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: LP uSigned by: Office of the Chief Financial Officer tA+6 u Date: 2/21/2015 e1�egeF�asr ... f? Legal Services This agreement is approved as to�eg9Pf611ffAhd sufficiency: Office of the County Attorneys Date: 2/23/2015 r i Clerk to the Board c Received for record retention: r All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@oran eg coup nc.gov The following signature block is for hard copies only and is not required for Docusign contracts: i Office of the Clerk to the Board Date: Revised 10/14 9