HomeMy WebLinkAboutR 2018-799 DSS - Charles House adult day care services DocuSign Envelope ID:6D51`41 E3-E7E2-4D6C-l3E76-951 E8674450E Contract#68-2040
Charles House Association
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Charles House Association PartyfVendor Contact Person: Paul Klever Contact Phone: (919) 967-7570
Party/Vendor Address: 7511 Sunrise Rd, City Chapel Hill State: NC Zip: 27514 Department: Social Services Amount: $24,000
Purpose:Adult Day Care Budget Codes): 10405020-764100&1 0405020-764 101 Vendor#19446 (N/A if new vendor) Vendor is a
BOCC consultant? Yes ❑ NoN Contract Type: (Check one)New❑ Renewal Z Amendment ❑ Effective Date July 1.2018
Approved by Board Yes❑NoZ Agenda Date:
This agreement is approved as to te, Docu5igned by: tent:
N bim 12/5/2018
Department Director's Signature Date:
DAE1E196A83B455...
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 sufficiene -6ocu5igned by: �t ' rds,specifications,and requirements:
Office of the Risk Management OfficerQuSa �,bVlrt.f,lib 7FDCF9176800498... Date:11/5/2018
Financial Services
This instrument has been pre-audited' Docusigned by: the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer 4� Date:12/7/2018
704E5181ACC1469...
Le-aal Services
This agreement is approved as t Docusigned by: :ncy:
12/7/2018
Office of the County Attorneyp35C68304CA4A9... Dale..
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@oyangecouMnc.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:
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