R 2016-404-E Health - Wake Medical Laboratory Consultants, Inc. for lab services for Family Planning

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DocuSign Envelope ID: 155D1985-9FE0-4EA7-B67C-F2531BFF9621 ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Wake Medical Laboratory Consultants, Inc. Party/Vendor Contact Person: Kerr Hughes Contact Phone: 248-763-8504 Party/Vendor Address: 3000 New Bern Avenue City Raleigh State:NC Zip: 27610 Department: Health Amount: $15.000 Purpose: Lab Services for Family Planning Budget Code(s): 10414020- 632000-71406 Vendor# 63158 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New❑ Renewal ® Amendment ❑ Effective Date 7/1/16 Approved by Board Yes❑No ❑ Agenda Date: This agreement is approved as to to el FIRffhy�id1Ac ntent: Imo` 7/26/2016 Department Director's Signature -o,,,,-,,, Date: Information Technolosies (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer Date: Risk Management This agreement is approved for sufficiency Iiaswswoistandards, specifications,and requirements: Qusa. r,Orwc,�16 7/26/2016 Office of the Risk Management Officer �,es,-s4z9,e04a8 Date: Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: DocuSigned by: 7/27/2016 Office of the Chief Financial Officer 7o4ES1a1ACC1409... Date: Legal Services This agreement is approved as t eg$TIMIM sufficiency: ��1�- 7/27/2016 Office of the County Attorney 4035CE8304CA4A9 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 6/16 8