Orange County NC Website
Browse       Search
A010 r3 <br /> ORANGE COUNTY--DEPARTMENT USE ONLY-HARD COPY ONLY <br /> Department <br /> PartyNendor Name: UNC Health Care System PartyNendor Contact Person: Kathryn Grant Contact Phone: 984- <br /> 974-1274 PmtyNendor Address: 211 Friday Center Drive City Chanel Hill State: NC Zip: 27517 Deparmrem: <br /> J ealdi Amount $30,000 Purpose: Perform tribal ligation for uninsured women Budget Code(s): 10414020- <br /> 0000-71400 Vendor # 30892 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract <br /> F (Check one) New E] Renewal ® Amendment ❑ Effective Date 7-1-18 Approved by Board Yes❑ No <br /> ❑ Agenda Date: <br /> This agreement is approved as to tec ' al form and content: µ <br /> Department Director's Signature��t Date: /LI //a <br /> Information Technologies <br /> (Applicable only to hardwaralsofeaare 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 sufficiency of insurance standards, specifications, and requirements: <br /> Office of Risk Management ax _ (,�0�n, �.�Date: —zi/z.k1(j> <br /> Financial Serv' <br /> This instrument has been pre-audited in the4mer tred y the Local Government Budget and Fiscal Control <br /> Act: <br /> Office of the Chief Financial Officer Date: D /8 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency:: <br /> Office of the County Attorney (/'hu L (a,: /K 6'-' Date: 1 y I30/ Ik <br /> Clerk to the Board <br /> Received for record retention: <br /> Office of the Clerk to the Board Date: <br /> Revised 10/17 <br />