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DocuSign Envelope ID:C147995A-34FD-4913-8C66-E8A65CCEA168 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: University of North Carolina- School of Medicine Party/Vendor Contact Person: <br /> Alison M. Melvin Contact Phone: 919-966-4548 Party/Vendor Address: 3140 Bioinformatics Building <br /> City Chapel Hill State: NC Zip: 27599 Department: Office of Professional Service Contracts and <br /> Affiliations Amount: 51,700 Purpose: EMS Medical Director's Contract Budget Code(s): 10- <br /> 7575206300 Vendor # N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® <br /> Contract Type: (Check one)New❑ Renewal® Amendment ❑ Effective Date 07-01-2019 Approved <br /> by Board Yes❑No® Agenda Date: <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively <br /> state work on this project has not been initiated prior to execution of the agreement: <br /> DocuSigned 6y: <br /> �{ 6/21/2019 <br /> Department Director's Signature Date: <br /> 5655BC89iAS4473. <br /> Agreements for emergency services or repair are not subject to the above affirmation. If services related to <br /> this agreement have already begun or been completed please briefly describe the nature of the emergency <br /> condition that was addressed: <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed <br /> and is 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 sufficienr--­oocusigned by:-`---",trds,specifications,and requirements: <br /> Office of the Risk Management OfficeaCisa �a Date.6/22/2019 <br /> 7FDCF9176900498. <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal <br /> Control Act: DocuSigned by: <br /> Office of the Chief Financial Officer A .&I. Date:6/21/2019 <br /> 704E5181ACC1409. <br /> Legal Services <br /> This agreement is approved as DocuSigned by: =y: <br /> Office of the County AttorneL-4035CB8'304C' <br /> Date:6/24/2019 <br /> A4A� <br /> Clerk to the Board <br /> Received for record retention: All Docusign contracts must be copied to Sherri Ingersoll upon completion: <br /> Singersoll@orangecountync.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 /> 7 <br />