HomeMy WebLinkAboutR 2015-296-E Aging - Senior Care Center for respite services DocuSign Envelope ID:20CF096F-CA74-409A-B90A-94B182005E1 E
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Senior Care Party/Vendor Contact Person: Alvonia Baldwin Contact Phone:
Party/Vendor Address: 105 Meadowlands Drive City Hillsborough State: NC Zip: 27278 Department: Aging
Amount: $12,000 Purpose: respite services Budget Code(s): 10432020-630105 Vendor 4 19446 (N/A if new vendor)
Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ® Amendment ❑
Effective Date July 1,2015 Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to technical form and content:
DocuSigned by:
Department Director's Signature � « � Date: 6/26/2015
B7E962D1BF454FA...
Information Technologies
(Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is
approved as to information technology content and specifications:
Office of the Chief Information Officer Date:
Risk Management
This agreement is approved for sufficiency of insurance standards,specifications,and requirements:
DocuSigned""by:
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Office of the Risk Management Officer a�lSa (,bnU& Date: 6/29/2015
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in th fA jdtVquired by the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer PMAL tA+bVu Date: 6/29/2015
232DFFC2CFA847B...
Legal Services
This agreement is approved as to le a�f��rsmn sufficiency:
Office of the County Attorney ✓ 0 1� Date: 6/29/2015
4035CB8304CA4A9...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloyLyorangecou go v
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board Date:
Revised 10/14 4