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HomeMy WebLinkAboutR 2017-410-E Aging - Flaircare Inc. for in-home services DocuSign Envelope ID:FB5D6D3D-DC01-4E94-9986-9211E65DE6B9 ORANGE COUNTY-DEPARTMENT USE ONLY Department Party/Vendor Name: Flaircare Inc. Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: 1210 SE Maynard Rd., Suite 202 City Cary State: NC Zip: 27511 Department: Aging Amount: $14,700 Purpose: in-home services Budget Code(s): 10432020-630100 & 630105 Vendor # 53657 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective Date 7/01/17 Approved by Board Yes' No Agenda Date: This agreement is approved as to technical form and content: -- /- ocu igned y: 8/18/2017 Department Director's Signature i 0-- I r Date: B7E962D1BF454FA... 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 of insurance standards, specifications, and requirements: 5---DocuSigned_by: 'll g a�SA. rbvvutl6 8/25/2017 Office of the Risk Management Officer Date: 7FDCF9176800498... Financial Services This instrument has been pre-audited in the maiNdricouired by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer Aniti 10,0x. Date: 8/25/2017 —7D4E5181 ACC1409... Legal Services This agreement is approved as to leAl forme ml sufficiency: ocu igne Office of the County Attorney ate, L SCo Date: 8/25/2017 079A4D525C0F4FB... Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd @orangecountync.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 2/17 5