HomeMy WebLinkAboutR 2017-335-E DSS - Charles House Association for adult day care 000vSign Envelope ID: eAoE4Cnr-70er-4uo0~^88E-o4081eE40eCA Contract#68-2009
Charles House Association
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Charles House Association Purh/Vuodor Contact Person: Paul Klevor Contact Phone: (919) 967-7570
Party/Vendor Address: 7511 Sunrise Rd. City Chapel Hill State: NC Zip: 27514 Department: Social Services Amount: $25`000
Purpose: Adult D Care Budget Code(s): 10405020-764100 Vendor# l0446 if new vendor) Vendor is a BOCC consultant?
Yes nEl Contract Type:(Check one)New 0 Renewal Amendment [l Effective Date July |.2817 Approved by Board },co
[lY4oN Agenda Date:
This agreement is approved as to te niniuMn Mid content:
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Department Director's Sigou1ucc\^_"^s,s,yv^o»e+o,— Date:
Information Technologies
(Applicable only to ha purchases or related services)This agr ement has been reviewed and is approved as to
information technology content and specifications:
Office of the Chief Information Officer Date:
Risk Management
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. Financial Services
This instrument has been pre-audited in Vivaitiverdliequired 6 the Local Government Budget and Fiscal Control Act:
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��8Oc*of the��hbxf Financial Officer [ °' Date:
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Legal Services
Thixu�eomm4isupproved sufficiency:
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K»yOccu[the oComu1y/kttormcy\._4v,xca^3o^cAw^» Date:
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloydAorangecountync.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:
Contract-General (07/10) Page 5 of 5