HomeMy WebLinkAboutR 2019-490 DSS - Premier Home Health Care contract amendment DocuSign Envelope ID: 147BE359-9EE3-4364-92AB-6619CE690DOB
GRANGE COUNTY DEPARTMENT USE ONLY
Party/Vendor Name: Premier Home Health Care Services, Inc. Patty/Vendor Contact Person: Grego GregoEy Turchan Contact Phone:
919-428-7722 PartylVendor Address:445 Hamilton Avenue City: White Plains State: NY Zip: 10601 Department: Social Services
Amount: $610.647/$75.000 Purpose: In-home aides services Budget Code(s): 10400220-630000/10400220-680026/10432020-
630100/10432020-630105 Vendor 9 4543 (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 executio DocuSigned by:
7�" (, Sf bvu 7/24/2019
Department Director's Signature QocuSlgned by: Date:
cI.I tu_ -�bw 7/24/2019
Department Director's Signature[B7E,,2D1BF454=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 Management
This agreement is approved for suf icienc Qocusigned by:-`--'-rds,specifications,and requirements:
QUs& c4VIA.t 6 7/10/2019
Office of the Risk Management Office 7FDCF9,76800498. Date:
Financial Services
This instrument has been pre-audited nE
cusigned by: the Local Government Budget and Fiscal Control Act:
O � 7/25/2019
Office of the Chief Financial Office4E5181ACC1409. Date:
Legal Services
This agreement is approved as tCL)ocuSigned by: ncy: 7/25/2019
Office of the County Attorney4035CB8304CA4M Da#e;
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@orangecountyne.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 12/18