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2024-112
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2024-112
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Last modified
6/17/2024 10:39:54 AM
Creation date
6/17/2024 10:38:28 AM
Metadata
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Template:
Official Documents
Official Document Type
Agreement
Approved Date
05/21/2024
Control Number
2024-112
Agenda Item Number
13.A.
Entity Name
Southeast Florida Behavioral Health Network, Inc.
Subject
Service Agreement for Administration of Opioid Class Action Lawsuit Settlement Fund Allocation
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DocuSign <br />Certificate Of Completion <br />Envelope Id: 1CDEA85EA82249BE928CC8EF57CBBF8F <br />Status: Completed <br />Subject: Agreement AGR75 (Indian River County Board of County Commissioners and Southeast Florida Behavior... <br />Source Envelope: <br />angie_vyas-knight@sefbhn.org <br />Document Pages: 40 Signatures: 5 <br />Envelope Originator: <br />Certificate Pages: 5 Initials: 0 <br />Angie Vyas-Knight <br />AutoNav: Enabled <br />10685 N Kendall Dr <br />Envelopeld Stamping: Disabled <br />Miami, FL 33176 <br />Time Zone: (UTC -05:00) Eastern Time (US & Canada) <br />angie_vyas-knight@sefbhn.org <br />Security Level: Email, Account Authentication <br />IP Address: 35.185.192.36 <br />Record Tracking <br />Status: Original <br />Holder: Angie Vyas-Knight <br />Location: DocuSign <br />6/12/2024 9:32:55 AM <br />angie_vyas-knight@sefbhn.org <br />Signer Events <br />Signature <br />Timestamp <br />Susan Adams <br />o1, <br />Sent: 6/12/2024 9:32:57 AM <br />sadams@ircgov.com <br />[11glld <br />S <br />L'&B 9 <br />Viewed: 6/12/2024 2:58:32 PM <br />Security Level: Email, Account Authentication <br />o<a�z <br />Signed: 6/12/2024 3:00:56 PM <br />(None) <br />Signature Adoption: Pre -selected Style <br />Using IP Address: 12.160.153.194 <br />Electronic Record and Signature Disclosure: <br />Accepted: 6/12/2024 2:58:32 PM <br />ID:fe54f24f-d902-486e-a41a-9e71e208cble <br />Ann M. Berner <br />(` Po S,gn.d by. <br />Sent: 6/12/2024 3:00:57 PM <br />ann_berner@sefbhn.org <br />Viewed: 6/12/2024 3:20:22 PM <br />President/CEO <br />A00748b,171F45C <br />Signed: 6/12/2024 3:20:54 PM <br />ANN BERNER <br />Security Level: Email, Account Authentication <br />Signature Adoption: Drawn on Device <br />(None) <br />Using IP Address: 174.61.101.35 <br />Electronic Record and Signature Disclosure: <br />Accepted: 6/10/2022 4:49:45 PM <br />ID: 116c845f-c7b24f16-94b5-75a097338d34 <br />In Person Signer Events <br />Signature <br />Timestamp <br />Editor Delivery Events <br />Status <br />Timestamp <br />Agent Delivery Events <br />Status <br />Timestamp <br />Intermediary Delivery Events <br />Status <br />Timestamp <br />Certified Delivery Events <br />Status <br />Timestamp <br />Carbon Copy Events <br />Status <br />Timestamp <br />Witness Events <br />Signature <br />Timestamp <br />Notary Events <br />Signature <br />Timestamp <br />Envelope Summary Events <br />Status <br />Timestamps <br />Envelope Sent <br />Hashed/Encrypted <br />6/12/2024 9:32:57 AM <br />Certified Delivered <br />Security Checked <br />6/12/2024 3:20:22 PM <br />
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