R 2015-583-E HR - Job Ready Services for Workplace Fitness

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DocuSign Envelope ID:6E9B5308-6677-4F2E-9268-29D6E1A4FD76 ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Job Ready Services Party/Vendor Contact Person: Deborah Lord Contact Phone: 919-256-1400 Party/Vendor Address: 2300 Westinghouse Blvd, Suite 107 City Raleigh State: NC Zip: 27604 Department: Amount: $15,000.00 Purpose: Workplace Fitness For Duty and Functional Capacity Testing For Certain Work Groups 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, 2015 Approved by Board Yes[:] No® Agenda Date: This agreement is approved as to tec 4pTiwrrdhd content: 10/23/2015 Department Director's Signature 0 Date: &'f E98Bz^69F9 48 F... Information Technologies 4 (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 Date: Risk Management This agreement is approved for sufficiency e"" tandards,specifications,and requirements: Q�SA r,6vvte tt0 10/23/2015 Office of the Risk Management Officer FDCr�,� ooasa__. Date: Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: DocuSigned by: Office of the Chief Financial Officer � � Date: 10/30/2015 B4C-1-81ACCA409... Legal Services This agreement is approved as to nbf &J d sufficiency: Office of the County Attorney Date: 11/3/2015 Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@oran ecopD tync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Revised 10/2015 10