Orange County NC Website
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Page 1 of 2 <br />11802 Ridge Parkway Suite 400 <br />Broomield, CO 80021 <br />REMIT TO ADDRESS <br />DEPT# 42374 <br />PO Box 650823 <br />Dallas, TX 75265-0823 <br />INVOICE <br />Bill <br />To: <br />Orange County Emergency Services <br />Sally Kadle Accounts Payable <br />131 W. Margaret Lane, STE 300 <br />Hillsborough, NC 27278 <br />Sold <br />To: <br />Orange County Emergency Services <br />510 Meadowlands Dr <br />Hillsborough, NC 27278 <br />Invoice Number Customer Number Invoice Date PO Number Invoice Due Date <br />INV00205217 147907 07/01/2025 2500200 07/31/2025 <br />Description/Module Service Period Quantity Unit Price Fee <br />Orange County Emergency Services <br />Charge Type: Recurring <br />AutoAttach for Scanned Documents <br />Ann Maint 08/01/2025 - 07/31/2026 1 686.40 686.40 <br />Billing Professional User Ann Maint 08/01/2025 - 07/31/2026 3 1,784.64 5,353.92 <br />Billing Professional User Ann Maint 08/01/2025 - 07/31/2026 3 1,784.64 5,353.92 <br />Patient Invoice - Single Trip ECM Ann <br />Maint 08/01/2025 - 07/31/2026 1 686.40 686.40 <br />Prepaid Custom Report Services Ann <br />Maint 08/01/2025 - 07/31/2026 1 100.10 100.10 <br />Professional Reports/Crystal Interface <br />Ann Maint 08/01/2025 - 07/31/2026 1 1,430.00 1,430.00 <br />WebPCR User License Ann Maint 08/01/2025 - 07/31/2026 1 686.40 686.40 <br />Subtotal: 14,297.14 <br />Subtotal:14,297.14 <br />Tax:0.00 <br />Total:14,297.14 <br /> Exhibit ADocusign Envelope ID: 60F0403B-6C09-4802-B118-B013BB3DD879