R 2017-383-E HR - Envision Pharmaceutical Services, LlC to provide claims admin and parmacy benefit services

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DocuSign Envelope ID: 57C7A907-5B58-49D3-A739-6F02F5DAADB5 ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Envision Pharmaceutical Services, LLC and United HealthCare Services, Inc. Party/Vendor Contact Person: Anne Ashbridge Contact Phone: 952-486-4328 Party/Vendor Address: 3131 RDU Center Drive, RDU Center II City Morrisville State: NC Zip: 27560 Department: Amount: $0 Purpose: To provide claims administration and phaumacy benefit services. Budget Code(s): 0 Vendor# 61007 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No0 Contract Type: (Check one)New Ef Renewal❑ Amendment ❑ Effective Date June 6,2017 Approved by Board Yes❑No Agenda Date: This agreement is approved as to to.s. oadulYlwm Rad content: blittAJA Department Director's Signature barh�uu Date: 8/9/2017 •:. .• 148F... Information Technologies (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer Date: Risk Management This agreement is approved for sufficiency of insurance standards,specifications,and requirements: • Office of the Risk Management Officer Date: Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control ACt: DocuSigned by: R, y � 2.* Office of the Chief Financial Officer ('D1EE5181ncc,aoo... Date: 8/9/2017 Legal Services This agreement is approved as to e etbied$j su ciency: gIA,Vut. hart, 6SGO 8/9/2017 Office of the County Attorney O79A41525COF4FR 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: