HomeMy WebLinkAboutR 2015-399-E Finance - Duke HomeCare & Hospice - 2015-16 Outside Agency Performance Agreement DocuSign Envelope ID: D40ODC89-B8BF-484E-8158-24FOOA82920D
ORANGE COUNTY—DEPARTMENT USE ONLY
Deuartment
Party/Vendor Name: Duke HomeCare & Hospice Party/Vendor Contact Person: BelleStarr Browning Contact
Phone: 919-620-3853 Party/Vendor Address: 4321 Medical Park Drive, Suite 101 City Durham State: NC Zip:
27704 Department: Finance & Adm. Srv. Amount:$ 1,000 Purpose: Outside Agency Performance Agreement
Budget Code(s): 10495050 710026 Vendor 4 50707 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑
NoX Contract Type: (Check one)New ❑ Renewal ❑ Amendment ❑ Effective Date July 1,2015 Approved by
Board YesX No❑ Agenda Date:June 16,2015
This agreement is approved as to tec 1X%?d &i1d content:
PMAL tA+bVu 8/5/2015
Department Director's Signature Date:
232DFFC2CFA847B...
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 o 8�� &dsgpdards,specifications,and requirements:
QLSA, (bvvt,e b 8/5/2015
Office of the Risk Management Officer F Date:
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
-DocuSign__ed by:
Office of the Chief Financial Officer �� +(��bw Date: 8/5/2015
232DFFC2CFA847B...
Legal Services
This agreement is approved as to le � �SUfficiency:
Office of the County Attorney Date: 8/7/2015
4035CB8304CA4A9...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloydLvorm-1gecolinlyne.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:
(Duke HomeCare&Hospice)
Orange County Outside Agency Performance Agreement Page 6 of 7
Rev. 6115