HomeMy WebLinkAboutR 2017-590-E Finance - Duke HomeCare & Hospice - Outside Agency Performance Agreement DocuSign Envelope ID:E522BFFC-A634-4A11-A162-195A3BE957A4
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Duke HomeCare & Hospice Party/Vendor Contact Person: BelleStarr Browning Contact
Phone: 919-479-0318 Party/Vendor Address: 4321 Medical Park Drive, Suite 101 City Durham State: NC Zip:
27704 Department: Finance & Administrative Services Amount: 1100 Purpose: FY 2017-18 Outside Agency
Performance Agreement Budget Code(s): 10495050710026 Vendor# 50707 (N/A if new vendor) Vendor is a
BOCC consultant? Yes ❑No Contract Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date
7/1/2017 Approved by Board Yes No Agenda Date: 6/20/2017
ocunnS' ne n by:
This agreement is approved as to technical for an co
Department Director's Signature 7 4E5181ACC1409... Date: 8/31/2017
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 in, no�7•��>' ass,,specifications, and requirements:
MSA. £IVIU. l6 10/19/2017
Office of the Risk Management Officer 7 �158QQn� Date:
Financial Services
This instrument has been pre-audited in the ma er Peempeim the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer 7D4E5181ACC1409... Date: 8/31/2017
Legal Services
ocuSigned by:
This agreement is approved as to legal form and su Iciency �
L1' Al, t.-tl' SC6 10/23/2017
Office of the County Attorney 079A4D525C0F4FB... Date:
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:
(Duke HomeCare&Hospice)
Orange County Outside Agency Performance Agreement Page 7 of 10
Rev. 7/17