HomeMy WebLinkAboutR 2019-477 DSS - Personalized Patient contract amendment DocuSign Envelope ID: FBCC2048-2774-4750-9EA4-440DA53C487A
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Personalized Patient Home Assistance Inc. Party/Vendor Contact Person: Dorothea Farrington Contact
Phone: 919-929-4943 Party/Vendor Address: 109 Concord Drive City: Chapel Hill State: NC Zip: 27516 Department: Social
Services Amount: $415,647/$75,000 Purpose: In-home aides services Budget Code(s). 10400220-630000/10400220-
680026110432020-630100/10432020-630105 Vendor 9 13754 (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 technical form and content and I as Department Director affirmatively state work on this project has
not been initiated prior to executionDocusigned by:
N � ('6� n. 7/19/2019
Department Director's Signature h�ocusigned by: Date:
Department Director's Signature g7E902D1BF454=A.. Date. 7/19/2019
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 Manaeemient
This agreement is approved for sufficient Qocusignea by: ` ' ids,specifications,and requirements.
aUSA c4VIA.t& 6/14/2019
Office of the Risk Management Office 7FDCF9176800408. Date:
Financial Services
This instrument has been pre-audited it oocusigned by: the Local Government Budget and Fiscal Control Act:
('q� 0." � 7/19/2019
Office of the Chief Financial Officer 7o4E15181ACC1409. Date:
Le al Services
This agreement is approved as ti D cuSigned by:' r ncy:
Office of the County Attorney � �,•4"" _ Date: 7/19/2019
4035Cg8304CA4M
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@orangecount)mc.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