HomeMy WebLinkAboutR 2019-637 DSS - Happy Homecare in home RN assessments DocuSign Envelope ID:75C616E5-76E4-43AA-986C-053F34F85F83
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Happy Homecare Staffing, Inc, Party/Vendor Contact Person: Lesa Kendrick Contact
Phone: 919-732-4663 PartylVendor Address: 6720 Pentecost Road City Cedar Grove State: NC Zip: 27231
Department: Social Services Amount;$10,000 Purpose: RN Services Budget Code(s): 10400220-622000 Vendor
4 59793 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New
❑ Renewal ® Amendment ❑ Effective Date July 1, 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 execution of the agreement:
DocuSigned by:
Department Director's Signature �bSf b5 Date: 9/17/2019
DAE1E198A83B455 .
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 sufficien( Qocusigned by: irds,specifications,and requirements:
Q�Sa �,DV1A.tr�b 9/17/2019
Office Of the Risk Management Office 7FDCF0176800408. Date:
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act: DocuSigned by:
lr7NE5181ACC1409
J 4 � 9/17/2019
Office of the Chief Financial Officer Date:
.
Legal Services
This agreement is approved as tiE41035CB8'304C'A4Ae
- Docusigned by:" - ncy:
Office of the County Attorney '" �' Inv.__ Date: 9/17/2019
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 6/19
9