HomeMy WebLinkAboutR 2016-586-E Finance - Senior Care of Orange County, Inc. - Outside Agency Performance Agreement DocuSign Envelope ID:4FFDF545-B8C1-4ABF-A6A5-400656A36357
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Senior Care of Orange County, Inc Party/Vendor Contact Person: Alvonia Baldwin Contact
Phone: 919-245-2017 Party/Vendor Address: 105 Meadowland Drive City Hillsborough State: NC Zip: 27278
Department: Finance & Administrative Services Amount: 30000 Purpose: Outside Agencies Funding Budget
Code(s): 10495050-719027 Vendor# 800047 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑
Contract Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date 7/1/16 Approved by Board Yes
®Nor-1 Agenda Date: 6/21/16
This agreement is approved as to technical form and efttWSigned by:
Department Director's Signature t� nnG�, Date:
Information Technolo0es
(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 ins ur ®mot lords, specifications,and requirements:
Qusa. COV'lnd 6
Office of the Risk Management Officer Date:
Financial Services
This instrument has been pre-audited in the manner r Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer 7 Date:
�B&Er1S4RCG 1409...
Legal Services
This agreement is approved as to legal form and su yS geed by:
Office of the County Attorney ff 4 1`� Date:
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydkorangecount.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:
(Senior Care of Orange County,Inc)
Orange County Outside Agency Performance Agreement
Rev. 8116