HomeMy WebLinkAboutR 2019-348 DSS - KAH Care-Right at Home contract amendment DocuSign Envelope ID:4B2345D6-005A-4A36-BAA2-26E7C59B79FA
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: KAH Care,L.L.C. dba Right at Home Party/Vendor Contact Person: Ken Helmuth Contact Phone: 919 241-
5292 PartyNendor Address: 4905 Pine Cone Dr., Suite 2 City: Durham State: NC Zip: 27707 Department: Social Services
Amount: $415,647/$75,00.0 Purpose: In-home aides services Budget Code(s): 10400220-630000/10400220-680026/10432020-
630100/10432020-630105 Vendor#62382 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type:
(Check one)New ❑ Renewal❑ Amendment ® Effective Date May 20,2019 Approved by Board Yes❑No❑ Agenda
Date:
This agreement is approved as to technicaI form and content and I as Department Director affirmatively state work on this project has
not been initiated prior to execution Docusigned by:
Noun A �b 6v, 6/17/2019
Department Director's Signature DAEi Docusigned by, Date:
�A.1R,iu_ -�bw 6/17/2019
Department Director's Signature _ B7E062D1BF454=A.. Date:
Agreements for emergency services or repair are not subject to the above affirmation. If services related to this agreement have
already begun or been completed please briefly describe the nature of the emergency condition that was addressed:
Information Technologies
(Applicable only to hardwarelsoftware 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 Manaaeme
This agreement is approved for sufficient---r:_-_.---Docusigned--dy:-.-_'--ds�specifications,and requirements:
gr pp
aUSA �,4VIA.t{�6 6/17/2019
Office of the Risk Management Officer Date;
7FDCF917E800495.
Financial Services
This instrument has been pre-audited z 7- Docusigned by: the Local Government Budget and Fiscal Control Act:
6/19/2019
Office of the Chief Financial Office Date:
04E51S1ACC1409.
Legal Services
This agreement is approved as t DocuSigned by: icy:
6/19/2019
Office of the County Attorney 4035CBS304CA4M Date:
Clerk to the Board
Received for record retention;
All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@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 12118