HomeMy WebLinkAboutR 2019-702 DSS - Personalized Patient Home Assistance Inc in home aide services DocuSign Envelope ID:412EAE5F-3824-43FA-AC95-54AOC4DF83A2 Contract468-2045
Personalized Patient Home Assistance, Inc.
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:$253,600 Purpose:In-home aides services BudgetCode(s): 10400220-630000/10400220-680026110432020-630100/10432020-
630105 Vendor 4 13754 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type: (Check one)New❑
Renewal® Amendment ❑ Effective Date October 1,2019 Approved by Board Yes®No❑ Agenda Date:May 7,2013
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:
UocuSignedd by:
Department Director's Signature�NDo��ned by: Date:10/1/2019
�c iu_ - �bw 10/1/2019
Department Director's Signature NE062D16F454=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 hardwarelso^are 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 sufficient IDocusigned by: y rds,specifications,and requirements:
Qus . C6�6 9/26/2019
Office of the Risk Management Officer 7FDCF0176800408. Date:
Financial Services
This instrument has been pre-audited' I7ocusigned by: the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer 7oaEs1a1ACC1400 Date 10/2/2019
Legal Services
This agreement is approved as t DocuSigned by: ncy:
1.
Office of the County Attorney h �` ' - Date: 10/2/2019
4035C68304CA4M
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:
Contract-General (06/19) Page 5 of 5