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7 <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />________________________________________________________________________ <br />Party/Vendor Name: University of North Carolina- School of Medicine Party/Vendor Contact Person: <br />Ginger Morgan Contact Phone: (919) 966-4559 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 07-01-2020 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 />Department Director’s Signature ________________________________________ Date: ________ <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 sufficiency of insurance standards, specifications, and requirements: <br />Office of the Risk Management Officer___________________________________ Date: _________ <br />Financial Services <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal <br />Control Act: <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br />Legal Services <br />This agreement is approved as to legal form and sufficiency: <br />Office of the County Attorney __________________________________________Date: ________ <br />Clerk to the Board <br />Received for record retention: <br />All Docusign contracts must be copied to Clerk upon completion: occlerkdocs@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 />DocuSign Envelope ID: 29CC76EA-9C26-4836-BFC9-F3A851B2B073 <br />11/8/2021 <br />11/8/2021 <br />Gary Donaldson 11/8/2021 <br />11/11/2021