Orange County NC Website
Browse       Search
r <br /> 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. Contract, for legal review should <br /> be completed through the legal review process prior to being routed for signature. <br /> Department <br /> Party/Vendor Name: KAH Care,L.L.0 Party/Vendor Contact Person: Kenneth Helmuth Contact Phone: 9t 191:x41-5292 Party/Vendor <br /> Address: 105 W. Corbin St Suite 203 City Hillsborough State:NC Zip:27278 Department: DSS Amount:J4 5.647 Purpose:Provide <br /> employees to perform in-home services for DSS clients and Dept on Aging clients Budget Code(s): 10400220-6 10000 Vendor# <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® Contract Type:(Check one)New❑ Renewal® Amendment <br /> ❑ Effective Date 07/01/14 Approved by Board Yes❑No® Agenda Date: Title of Contract: In=Home Aide Provider <br /> 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: G Date: <br /> T Director <br /> (Applicable only to hardware/software purchases or related services)T�his contract has been reviewed and approved by the Information <br /> Technology Director as to technical content and information tech n gy specifications: <br /> IT Director's Signature: Date: <br /> Risk Mana cement r <br /> Include the following coverages: D-CGL;4�Mto; ®''WC; rofessional; rl 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: <br /> QD <br /> Risk Manager's Signature: 1 Date: <br /> 71z:l JUL 21 2014 <br /> Financial Services <br /> This Contract is conditioned j4pon appropriation by the Board of Commissioners Yes❑NoE% A bud mendment is necessary <br /> before approval Yes❑No M. If budget amendment is necessary,please attach to this form. This instrument <br /> manner required by the Local Government Budget and Fiscal Cool Act* <br /> Financial Services Director's Signature: ' Date: I l <br /> County Attorney <br /> Approval by Board ❑ (Contracts $90,000.00 or more for goods or services, $250,000.00 or more for construction, or any BOCC <br /> consultant contract). Approval by nager❑(Most other contracts$1,000 and above). Department Director approval only❑(Under <br /> $1,000). This contract has been re i ed and approved by the Attorney as to legal form and sufficiency: Q�1�_ <br /> Attorney's Signature Date: �L <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yes No❑. <br /> This contract has been reviewed and is for signatujr�by the Chair Yes❑No❑. <br /> Manager's Signature: Date: <br /> Clerk tot oard <br /> Approved by BOCC on the T day of ,20 . Submitted for Chair signature on the_day of ,20 <br /> Clerk's Signature: Date: <br /> Revised March 2012 <br />