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I <br /> Contract#68-2004 <br /> Personalized Patient Home Assistance,Inc. <br /> CONTRACT# 68-2004 Fiscal Year Begins Julyl,2010 Ends June 30,2011 <br /> NORTH CAROLINA <br /> ORANGE COUNTY <br /> IN-HOME AIDE PROVIDER SERVICES AGREEMENT <br /> THIS AGREEMENT, is made and entered into this _day of , 2010 by <br /> and between Orange County,North Carolina for and on behalf of the Orange County Department <br /> of Social Services and the Orange County Department of Aging (the "County"); and <br /> Personalized Patient Homes Assistance, Inc. (the ") whose federal tax identification <br /> number or Social Security Number is: 56-1629016 <br /> WITNESSETH: <br /> For the purpose and subject to the terms and conditions hereinafter set forth,the County <br /> hereby contracts for the services of the Contractor,and the Contractor agrees to provide the <br /> services to the County in accordance with the terms of this Agreement. <br /> 1. Contract Documents: This Agreement consists of this document as well as each of the <br /> documents listed below as indicated(collectively referred to as the"Contract Documents"). If <br /> the word"Yes"appears beside the title of the contract document at the time both parties execute <br /> this Agreement,then that document is included as part of this Agreement. If the word"No" <br /> appears beside the title of the contract document at the time both parties execute this Agreement, <br /> then that document is not included as part of this Agreement. Each of the Contract Documents <br /> made part hereof are attached hereto and incorporated herein by reference to the same: <br /> TITLE OF CONTRACT DOCUMENT YES/NO <br /> (1) The General Terms and Conditions(Attachment A) YES <br /> (2) The Scope of Work,services,and rate(Attachment B) YES <br /> (3) Federal Drug Free Workplace Certification(Attachment C) YES <br /> (4) Conflict of Interest Policy(Attachment D) YES <br /> (5) No Overdue Taxes Certification(Attachment E) YES <br /> (6) Certification Regarding Lobbying(Attachment G) YES <br /> (7) Certification Regarding Debarment(Attachment H) YES <br />