R 2016-342-E Health - Dixon Hughes Goodman, LLP to prepare analysis of 2014 Cost Report

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DocuSign Envelope ID:63B49CO3-DB46-4935-A8E4-1E08211FDE8D ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Dixon Huges Goodman, LLP Party/Vendor Contact Person: Kristi Chestnutt Contact Phone: 919-526-1824 Party/Vendor Address: 2501 B1ueRidge Road, Suite 500 City Ralei State: NC Zip: 27607 Department: Health Amount: $2,000 Purpose: Prepare analysis of 2014 Cost Report Budget Code(s): 10410020- 630000 Vendor#63893 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No[] Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 7/1/16 Approved by Board Yes❑ No❑ Agenda Date: This agreement is approved as to to and content: (,�� Department Director's Signature Date: 6/30/2016 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 sufficient g , g„standards, specifications,and requirements: Q ,SX r,Orin,c,�16 6/30/2016 Office of the Risk Management Office Date: Financial Services This instrument has been pre-audited i e°iffiftWVTV p�quired by the Local Government Budget and Fiscal Control Act: ita Office of the Chief Financial Officer4a,A ,4os Date: 7/8/2016 Legal Services This agreement is approved as t egRTCr18Rff''�d sufficiency: Office of the County Attorney Date: 7/8/2016 �,1 3' 4035CB83D4CA4A9... Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloy(d c�orangecount.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 1/16 5