R 2016-137-E Health - Mental Health America of the Triangle - Amendment to navigator agreement

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DocuSign Envelope ID:7190449A-3B32-4622-B7F4-C359EAAB94BA ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Mental Health America of the Triangle Party/Vendor Contact Person: Marci White Contact Phone: 919-942-8083 Party/Vendor Address: PO Box 16246 City Chapel Hill State: NC Zip: 27516 Department: HEALTH Amount: 4.800 Purpose: Navigator Agreement Amendment Budget Code(s): 10412020-681000-71453 Vendor # 63372 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ❑ Renewal ❑ Amendment ® Effective Date 1/1/16 Approved by Board Yes❑No❑ Agenda Date: This agreement is approved as to to /c°8PM �d c ntent: l�Z �� 2/2/2016 Department Director's Signature ee�s�a�a�€... Date: Information Technolosies (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 i ane standards, specifications,and requirements: QUSA. r,Orv�,c,r16 2/2/2016 Office of the Risk Management Officer 9,�,9„0A� Date: Financial Services This instrument has been pre-audited in e Y1sM1 YRjuired by the Local Government Budget and Fiscal Control Act: ta Office of the Chief Financial Officer Li 7D4E5181ACC1409... Date: 2/2/2016 Legal Services This agreement is approved as t eAWlCf." . sufficiency: -��-�� 2/3/2016 Office of the County Attorney a� S ,RR,�a�,odo, Date: Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydkorangecount.nic.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board Date: Revised July 2015