R 2017-299-E Health - Melynee Falk for regional audiology consulting services

Browse Search

DocuSign Envelope ID: 167F763C-D16E-41 D3-B98F-F5E24EE9CC37 ORANGE COUNTY-DEPARTMENT USE ONLY Department Party/Vendor Name: Melynee Falk Party/Vendor Contact Person: Meylnee Falk Contact Phone: 336-402-1025 Party/Vendor Address: 803 Seven Oaks Drive City Greensoboro State: NC Zip: 27410 Department: Health Amount: $77,597 Purpose: Regional audiology consulting services Budget Code(s): 10414020-630000 Vendor# 64366 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ❑ Renewal® Amendment ❑ Effective Date 6/1/17 Approved by Board Yes No Agenda Date: This agreement is approved as to tec n laid d content: L6ttUl LLAAJt 7/12/2017 Department Director's Signature s,a5 2eD9a�eanF 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 t r _ staandards,specifications, and requirements: MS& rbvvutl6 7/13/2017 Office of the Risk Management Office �,$6$gen� Date: Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: DocuSigned by: Crl ` n .A.x. 7/13/2017 Office of the Chief Financial Officer�oaes1a1accian9 Date: Legal Services This agreement is approved as t Ei4 tUrnV,i'd♦�-��sufficiency: bUAL rv�OU'tL 1 S(6 7/13/2017 Office of the County Attorney Date: 079n1DS2SCOr4Fe... 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 2/17 8