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DocuSign Envelope ID: 7918E906- 4978- 4DF3- 996D- 879CB7628380 <br />ORANGE COUNTY- DEPARTMENT USE ONLY <br />Department <br />Party/Vendor Name: MediSolutions Inc. Party/Vendor Contact Person: Robin Creason Contact Phone: 336 -329- <br />9060 Party/Vendor Address: 100 N. Church St, City Burlington State: NC Zip: 27217 Department: DSS <br />Amount: 10,000 Purpose: RN Services Budget Codc(s): 10400220 622000 Vendor # NA (N /A if new vendor) <br />Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ <br />Effective Date February 12018 Approved by Board Yes❑ No® Agenda Date: <br />This agreement is approved as to to Dacusigned by: <br />Nam W6w <br />Department Director's Signature oaElE196a83B455... <br />tent: <br />Information Technologies <br />6/29/2018 <br />Date: <br />(Applicable only to hardware /software purchases or related set-vices) This agreement has been reviewed and is <br />approved as to information technology content and specifications: <br />Office of the Chief Information Officer <br />Risk Management <br />This agreement is approved for sufficient Docusigned by: <br />Q�ISa ('6VL�.t,{�6 <br />Office of the Risk Management Office 7FDCF91768004ss_. <br />Date: <br />rds, specifications, and requirements: <br />Financial Set-vices <br />6/29/2018 <br />Date: <br />This instrument has been pre - audited in the mariner required by the Local Government Budget and Fiscal Control <br />Act: Docusigned by: <br />A.&I. 7/3/2018 <br />Office of the Chief Financial Officer ` o4E��s1acC1409 . -. Date: <br />Legal Services <br />This agreement is approved as t Docusigned ay: <br />Office of the County Attorney. a o35CBS304i;n4as... <br />ley: <br />Clerk to the Board <br />Date: <br />7/3/2018 <br />Received for record retention: <br />All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecountync,goy <br />The following signature block is for hard copies only and is not required for Docusign contracts: <br />Office of the Cleric to the Board <br />Revised 10117 <br />