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DocuSign Envelope ID:E8C538EF-9595-4E36-A4C9-2CA66C7BE34A <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Envision Pharmaceutical Services, LLC. Party/Vendor Contact Person: Lisa Venn Contact <br /> Phone: 330-405-8089 Party/Vendor Address: 2181 E. Aurora Road, Suite 201 City Twinsburg State: OH Zip: <br /> 44087 Department: Amount: $9,179,000.00 Purpose: Pharmacy Benefit Management Services Agreement <br /> Budget Code(s): 70395220/999990 Vendor#64731 (N/A if new vendor) Vendor is a BOCC consultant? Yes <br /> ❑ No0 Contract Type: (Check one) New 0 Renewal ❑ Amendment ❑ Effective Date July 1, 2017 <br /> Approved by Board Yes 2 No ❑ Agenda Date: April 6,2017 <br /> This agreement is approved as to to nic49f ma co tent: <br /> bruA,A barttotookuv 8/28/2017 <br /> Department Director's Signature ,2„FF Date: <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficient q'h s /o "d0 tallndards,specifications, and requirements: <br /> attsa, C,ortAkftb 9/18/2017 <br /> Office of the Risk Management Officer 7FncF9176800498 Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: DocuSigned by: <br /> rl A" 2art, 9/27/2017 <br /> Office of the Chief Financial Officer 71)4F5181ACC1409 Date: <br /> Legal Services <br /> This agreement is approved as to e m fIb P lefi1 sufficiency: <br /> MO 9/27/2017 <br /> Office of the County Attorney 079A4D525C0F4FB... Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> All DocuSign contracts must be copied to Donna Lloyd upon completion @ Dolloyd @orangecountync.gov <br /> The following signature block is for hard copies only and is not required for DocuSign contracts: <br /> Office of the Clerk to the Board Date: <br />