HomeMy WebLinkAboutR 2015-302-E DSS - Bethesda Care, LLC dba Keston Care for RN services DocuSign Envelope ID: 10E673C3-E710-42EA-A3C9-4B338A28EADF
ORANGE COUNTY—DEPARTMENT USE ONLY
NOT A CONTRACT EXHIBIT OR ATTACHMENT
Department
Party/Vendor Name: Bethesda Care, L.L.0 dba Keston Care Party/Vendor Contact Person: Roxanne Kessler Contact
Phone: (919)967-0507 Party/Vendor Address: 1 1312 US 15-501,Chatham Crossing Suite 400 City Chapel Hill State:
NC Zip: 27517 Department: Social Services Amount: $10,00 0 Purpose: RN Services Budget Code(s):
Vendor#N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New
® Renewal ❑ Amendment ❑ Effective Date March 30, 2015 Approved by Board Yes❑ No® Agenda
Date:
This agreement is approved as to technical forma p.ned by:
NAB �"StbIA' 6/11/2015
Department Director's Signature E_4
ea.�14)Zb183B45� Date:
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 Director of Information Technology Date:
Risk Management
This agreement is approved for sufficiency 7FDf_F91:T&8Q0498 a-j � "& specifications, and requirements:
sa, r,6m,&b 6/12/2015
Office of Risk Management Date:
Financial Services
This instrument has been pre-audited in the manne a rb �e Local Government Budget and Fiscal Control Act:
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Office of the Chief financial Officer Date: 6/29/2015
DFF
Legal Services
This agreement is approved as to legal form and su euSigned by:
Office of the County Attorney -�� Date: 6/29/2015
Clerk to the Board
Received for record retention: oocuSigned by:
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Office of the Clerk to the Board Date: 6/30/2015
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Revised 7114 4