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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/Vendor Name: Premier Home Health Care Services,Inc. Party/Vendor Contact Person: Gregory Turchan/Kathleen Craig Contact <br /> Phone:(919)428-7722 Party/Vendor Address:445 Hamilton Ave. 10th Floor City White Plains State:NY Zip: 10601 Department: <br /> DSS Amount: $415,647 Purpose:Perform In-Home health services Budget Code(s): 10400220-63000 Vendor# (N/A if new <br /> vendor) Vendor is a BOCC consultant? Yes❑No❑ Contract Type: C ck one)New❑ Renewal® Amendment ❑ Effective <br /> Date 07/01/2014 Approved by Board Yes2 No❑ Agenda Date:;�Title of Contract:In-Home Aide Provider Services <br /> 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: 6TjQ-1_(4 <br /> IT Director <br /> (Applicable only to hardware/software purchases or related services)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 /> Risk Management <br /> Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; OR No Insurance Required ❑. Hold <br /> Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as sho <br /> by the Risk Manager: D M <br /> Risk Manager's Signature: <br /> a-�e Date /1K JUL 2 5 2014 <br /> Financial Services Z:p <br /> This Contract is conditioned on appropriation by the Board of Commissioners Yes❑No[� A bu amnd�wnt is nP�A�c T <br /> before approval Yes❑Novi, budget amendment is necessary,please attach to this form. This instrument has been pre-audited m the <br /> manner required by the Local Government Bud et and Fiscal Control ,,t- <br /> Financial Services Director's Signature: �' J1''". . Date: <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 Managerx(Most other contracts$1,000 and above). Department Director approval only ❑(Under,, <br /> $1,000). This contract has b view approved by the Attorney as to legal form and sufficiency:—gqy, V'' <br /> � <br /> Attorney's Signature Date: I 3o — Sl 1Z 13 <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yes[ Nom. <br /> This contract has been reviewed and is for z7rwz�No❑. <br /> �/) 1 <br /> Manager's Signat ure: Date: <br /> l <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 />