R 2018-205 Health - Elavon credit card fees

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Revised 2/17 ORANGE COUNTY---DEPARTMENT USE ONLY---HARD COPY ONLY ______________________________________________________________________________ Department Party/Vendor Name: Elavon, Inc. Party/Vendor Contact Person: Todd Johansen Contact Phone: 800-226-9332 x8186 Party/Vendor Address: PO Box 86 City Minneapolis State: MN Zip: 55486 Department: Health Amount: $9,000 Purpose: Payment of credit card fees Budget Code(s): 10410020-682002 Vendor # 64920 (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date 6/26/18 Approved by Board Yes No Agenda Date: This agreement is approved as to technical form and content: 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 of insurance standards, specifications, and requirements: Office of Risk Management_____________________________________________ Date: _________ Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer ____________________________________ Date: _________ Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney __________________________________________Date: ________ Clerk to the Board Received for record retention: Office of the Clerk to the Board __________________________________________Date:_________ DocuSign Envelope ID: 7BAFA4EF-DE91-4D64-A904-630EDDFF2843 6/14/2018 6/15/2018 6/15/2018 6/15/2018 6/15/2018