R 2017-261-E Health - Dixon Hughes Goodman, LLP to prepare analysis of 2016 Cost Report

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DocuSign Envelope ID:832DFDF3-2A7B-415B-AF03-6A9B7508B20F 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 BlueRidge Road, Suite 500 City Raleigh State: NC Zip: 27607 Department: Health Amount: $5,500 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 7-1-17 Approved by Board Yes No Agenda Date: This agreement is approved as to tec 71:116PfilW A�ce�ass4aF content: e 4u vL� 6/30/2017 Department Director's Signature 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 sufficiency n'i st '_astanndards,specifications,and requirements: U.�tS& 6.611/ .J 6 7/3/2017 Office of the Risk Management Officer � Fg17e4� Date: Financial Services This instrument has been pre-audited i E Drif3NPVNuired by the Local Government Budget and Fiscal Control Act: � ` n '`°` 7/3/2017 Office of the Chief Financial Officer 704F51s1ACC14o0 Date: Legal Services This agreement is approved as t B.t flna"il�d'-��sufficiency: tAAAA. (fto4 tL 1 S(6 7/3/2017 Office of the County Attorney o79n1o52SCOF4FB... Date: Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecountync.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