HomeMy WebLinkAboutR 2016-492-E Aging - Flaircare dba Homewatch CareGivers for in-home services DocuSign Envelope ID: C33B4E4E-6357-44A2-8A64-68BO07EOF277
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Flaircare dba Homewatch CareGivers Party/Vendor Contact Person: Anzor Gachechiladze
Contact Phone: 919-960-6038 Party/Vendor Address: 101 Cosgrove Ave., Ste 120 City Chapel Hill State: NC Zip:
27514 Department: Aging Amount: $14,700 Purpose: in-home services Budget Code(s): 10432020-630105 Vendor
# 53657 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑
Renewal® Amendment ❑ Effective Date Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to technical form and content:
Docu5igned by:
Department Director's Signature ,WAA*a. :�(.W Date: 8/24/2016
67E962D1BF454FA...
Information Technolosies
(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: 11i1
Office of the Risk Management Officer allSA. ('6nA '',ll b Date: 8/25/2016
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in h &N %quired by the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer el-m °'� Date: 8/25/2016
7D4E5181ACC1409...
Legal Services
This agreement is approved as to legal form and sufficiency:
igned by:
Office of the County Attorney DocuS Date: 8/26/2016
4035CE8304CA4A9...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloy(d c�orangecount.nic.gov
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 6/16 5