HomeMy WebLinkAboutR 2016-501-E Aging - A Helping Hand for in-home services (2) DocuSign Envelope ID:2AFB7829-0884-48C4-969F-481222A1BCE1
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: A Helping Hand Party/Vendor Contact Person: Jennifer Ashlev Contact Phone: 919-403-5555
Party/Vendor Address: 1502 W NC Hwy 54, Ste 405 City Durham State: NC Zip: 27707 Department: Agin
Amount: $14,280 Purpose: in-home services Budget Code(s): 10432020-630105 Vendor # 32018 (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 tec7i ,,f9WQd content:
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Department Director's Signature Date: 8/30/2016
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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:
Docu5igned by:
Office of the Risk Management Officer USA. (,6nAA 111i 6 Date: 8/30/2016
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in the 0 u nenre squired by the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer (� `�°'�" °'v Date: 8/30/2016
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Legal Services
This agreement is approved as to legal form and sufficiency:
DocuSigned by:
Office of the County Attorney Date: 9/1/2016
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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