R 2017-638-E Health - Health Ascent Associates, LLC to provide Interim Health Director services

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DocuSign Envelope ID:CDCEC775-C81E-44AD-AB72-5C4ADF26C195 ORANGE COUNTY-DEPARTMENT USE ONLY Department Party/Vendor Name: Health Ascent Associates, LLC Party/Vendor Contact Person: Dr. Dorothy Cilenti Contact Phone: 919-360-0039 Party/Vendor Address: 238 Trout Lily Lane City Pittsoboro State: NC Zip: 27312 Department: Health Amount: $6,300 Purpose: Provide Interim Health Director Services Budget Code(s): 10410020-630000 Vendor#64876 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 11-22-17 Approved by Board Yes No Agenda Date: This agreement is approved as to to .c l ltd content: Department Director's Signature Date: 11/22/2017 050C5E2C74804E9... 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 -utzetanneaystandards,specifications, and requirements: MS& CbYliuth 11/22/2017 Office of the Risk Management Officer 7PDsRs4z680e49a Date: Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: DocuSigned by: Office of the Chief Financial Officer �� Date: 11/22/2017 7D4E5181ACC1409... Legal Services This agreement is approved as tr, -;y1c06MfidNid sufficiency: / tAAAA. SCb 11/22/2017 Office of the County Attorney t179�mix25C-er4n3... 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 10/17 9