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ORANGE COUNTY—CONTRACT CONTROL SHEET <br /> Routing Order: (1)Department,(2)IT,(3)Risk Management,(4)Financial Services,(5)Attorney,(6)Manager,(7)Clerk <br /> This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. If the Manager <br /> determines the contract is not appropriate for Manager approval the Manager shall submit the contract for BOCC approval. Contracts for <br /> BOCC approval must be submitted through,and complete,the routing process prior to agenda review. Contracts for legal review should <br /> be completed through the legal review process prior to being routed for signature. <br /> Department <br /> Party/Ven r Name: Premier Home Health Care Services Inc. Party/Vendor Contact Person: Gregory Turchan Contact Phone: 914- <br /> 428- 2 P rty/Vendor Address:445 Hamilton Ave. 10`''Fl City White Plains State:NY Zip: 10601 Department:DSS Amount: <br /> 647 ose:In-Home health services Budget Code(s): 10400220-630000 Vendor#45431 (N/A if new vendor) Vendor is a <br /> BO onsultant? Yes❑No❑ Contract Type: (Check one)New❑ Renewal® Amendment ❑ Effective Date 07/01/13 <br /> pproved by Board Yes®No❑ Agenda Date: 05/07/13 Title of Contract: In-Home Aide Provider Services Agreement <br /> If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners Yes❑No❑. If submitted for bid were <br /> bids/RFPs received Yes[]No[] Bid/RFP number This contract has been reviewed and approved by the Department Director as to <br /> technical content: <br /> Department Director's Signature: Date: <br /> � IT Director <br /> (Applicable only to hardware/softwa*ases ted sery ices)This contract has been reviewed and approved by the Information <br /> Technology Director as to technical content and information technology specifications: <br /> IT Director's Signature: Date: <br /> Fisk Management <br /> Include the following coverages: &00c"GL; [3KAuto; 3KWC, ❑ Professional; ❑ Property; OR No Insurance Required + Hold <br /> Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shown, this contract is approved <br /> by the Risk Manager: d� <br /> Risk Manager's Signature: � "' k-�� /� Date: 7 <br /> Financial Services <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No� A budget amendment is necessary <br /> before approval Yes[:]Noy. budget amendment is necessary,please attach to this form. This instrument has been pre-audited in the <br /> manner required by the Local Government Budget and Fiscal Contrct: <br /> Financial Services Director's Signature: Date: 7 ✓r 3 <br /> County Attorney <br /> Approval by Board ❑ (Contracts $90,000,0,p or more for goods or services, $250,000.00 or more for construction, or any BOCC <br /> consultant contract). Approval by Manager J�-,y or <br /> other contracts$1,000 and above). Department Director approval only❑(Under <br /> $1,000)rh"..This contract �b n re i ed dd aapp/prQved by tl}eA ttorn as to legal form and sufficie cy: <br /> Attorney's Signature (��// C� Date: Z11 (� <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Ye <br /> This contract has been reviewed and is for ' nature by t Chair Yes❑N <br /> Manager's Signature: Date: 7 - 5(-/3 <br /> Clerk to the Board <br /> Approved by BOCC on the_day of 20 . Submitted for Chair signature on the_day of 20 <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />