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DocuSign Envelope ID:83953149-A2B0-4F9F-A63C-BE4C32065413 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> ]Party/Vendor Name: MediSolutions Inc. PartyNendor Contact Person: Robin Creason Contact Phone: 336-329- <br /> 9060 PartyNendor Address: 100 N. Church St. City Burlinp�ton State: NC Zip: 27217 Department: Social <br /> Services Amount: $15,000 Purpose: RN Services Budget Code(s): 10400220-6 622000 Vendor#NA, (NIA if new <br /> vendor) Vendor is a B®CC consultant? Yes ❑ NoE Contract Type: (Check one) New ❑ Renewal Z <br /> Amendment ❑ Effective Date Jul Approved by Board Yes[]No® Agenda Date: <br /> This agreement is approved as to tec DocuSigned by: ;ent: <br /> EDAEIE196A83&455(him 9/13/2018 <br /> Department Director's Signature .. Date. <br /> Information Technoio ies <br /> (Applicable only to hardwarels©ftware 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 suffZcienc: IDocusigned by:' '- 'ds,specifications,and requirements: <br /> Q�tSa �,4W�.t,i�b 9/5/2018 <br /> Office of the Risk Management Officer 7FDCF917E800498... 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: Docu5igned by: <br /> 01.441. 9/13/2018 <br /> Office of the Chief Financial Officer[704E518lAr-C1469.-. Date: <br /> Legal Services <br /> This agreement is approved as tc ooeusigned by:' "° ncy: <br /> Date: <br /> Office of the County Attorney[_�4,,,,B,,04,A4A.... _ <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dollpydgjorangecggat3Mc.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 /> Revised 10/17 <br /> 8 <br />