R 2016-542-E Health - Dixon Hughes Goodman, LLP to prepare analysis of 2016 Cost Report

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DocuSign Envelope ID: 1 EF49E613-1 EFO-47A4-BA6D-5E74D5138GF9 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 Raleigh State: NC Zip: 27607 Department: Health Amount: $6,200 Purpose: Prepare analysis of 2016 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 9/23/16 Approved by Board Yes❑ No❑ Agenda Date: This agreement is approved as to to ni8atuRAi`l44'%d content: ��_ 9/27/2016 Department Director's Signature €oaslaG-o�sa� Date: Information Technologies (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 sufficienc 6(i Ys'tandards, specifications, and requirements: AUSa. (hnutl6 9/27/2016 Office of the Risk Management Officer Date: Financial Services DocuSi ned b This instrument has been pre-audited i the manner by: by the Local Government Budget and Fiscal Control Act: � p 9/27/2016 Office of the Chief Financial Officer M4E5181ACC14o9... Date: Legal Services This agreement is approved as to Ee7g9f T6 ?ReAllU sufficiency: �i V-_ 9/28/2016 Office of the County Attorney 4os5cea1o4cA4A9 Date: Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dollo d&oran etync. oovv 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