Orange County NC Website
Browse       Search
DocuSign Envelope ID: 7D9491 BE-DD6D-4897-B77A-CD2FD6CC19A7 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: ROBERT DUPUIS Party/Vendor Contact Person: ROBERT DUPUIS Contact Phone: 919-966- <br /> 4131 Party/Vendor Address: 205 KENILWORTH PLACE City CHAPEL HILL State: NC Zip: 27516 Department: <br /> HEALTH Amount: $12,645 Purpose:PHARMACY SERVICES Budget Code(s): 10414020-630000 Vendor 4 47361 <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New ❑ Renewal <br /> ® Amendment ❑ Effective Date 7/1/2015 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to to LR��hyid c ntent: <br /> �-� �� 8/5/2015 <br /> Department Director's Signature Q�FC�s�a�- Date: <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficient o iiubaa >:standards, specifications,and requirements: <br /> Qusa, r,6vvte& 8/5/2015 <br /> Office of the Risk Management Office Date: <br /> Financial Services <br /> This instrument has been pre-audited i ��hV P1 ired by the Local Government Budget and Fiscal Control Act: <br /> qlA� M 8/6/2015 <br /> Office of the Chief Financial Officer Date: <br /> Legal Services <br /> This agreement is approved as t a4-f@la l sufficiency: <br /> Office of the County Attorney 44� �1� Date: 8/7/2015 <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloyLyorangecou go v <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> Office of the Clerk to the Board Date: <br /> Revised July 2015 4 <br />