HomeMy WebLinkAboutR 2015-341-E DSS - Personalized Patient Home Assistance, Inc. - employees to perform in-home services for OC DSS clients DocuSign Envelope ID: 1582AE24-D793-4A66-9311-4472000BOEC3
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Personalized Patient Borne Assistance Inc. Party/Vendor Contact Person: Dorothy
Farrington Contact Phone: (919) 929-4943 Party/Vendor Address: 109 Concord Dr City Chapel Hill State: NC
Zip: 27516 Department: DSS Amount: $75,000 Purpose: Provide em to :ees to perform in-home services for
OCDSS clients Budget Code(s): 10400220-630000 Vendor 9 58844 (N/A if new vendor) Vendor is a BOCC
consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ® Amendment
07/01/15 Approved by Board Yes®No❑ Agenda Date: [I Effective Date
This agreement is approved as to technical fo ttht;
f�a.y ed,$7-0
Department Director's Signature Dad/16/2015
Information Technolo2jes
(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 Mana ement
This agreement is approved for sufficiency of insura andisf*,bripecifications, and requirements:
17�,EDCE917Q6QQ498_ISa, 66vvt,e 6 7/14/2015
Office of the Risk Management Officer Da te:
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act: DocuSigned by:
Office of the Chief Financial Officer PXAL to D""`bvu 7/16/2015
ae��sas�aa4zA Date:
Legal Services
This agreement is approved as to legal form and figi a by:
7/16/2015
Office of the County Attorney 4� l 1� Date:
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dollo =dLworangecount ync. ov
The following signature block is for hard copies only and is not required for Docusign contracts: