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DocuSign Envelope ID: 30CC97DC-995F-48ED-9245-A640EBC3CAOC <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> NOT A CONTRACT EXHIBIT OR ATTACHMENT <br /> Department <br /> Party/Vendor Name: Bethesda Care, L.L.0 dba Keston Care Party/Vendor Contact Person: Roxanne Kessler Contact <br /> Phone:(919)967-0507 Party/Vendor Address: 11312 US 15-501,Chatham Crossing Suite 400 City Chapel Hill State: <br /> NC Zip: 27517 Department: Social Services Amount: $10,000 Purpose: RN Services Budget Code(s): <br /> Vendor#N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes❑ No® Contract Type: (Check one)New <br /> ❑ Renewal ® Amendment ❑ Effective Date July 1, 2015 Approved by.Board Yes❑ No® Agenda Date: <br /> This agreement is approved as to technical form an MVgned by: <br /> Nawc� <br /> Department Director's Signature (hSt6v, Date: 7/10/2015 <br /> s�AeIer�s... <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Director of Information Technology Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of i w0andords,specifications,and requirements: <br /> Q�iSa r,6Viit,t�0 <br /> Office of Risk Management 1769004Q Date: 7/15/2015 <br /> Financial Services <br /> This instrument has been pre-audited in the manner e &&i yl ocal Government Budget and Fiscal Control Act: <br /> b�L 7/16/2015 <br /> Office of the Chief Financial Officer 232DF_Fr2CFA847B_ Date. <br /> Legal Services <br /> This agreement is approved as to legal form and su ®�1!uriibned by: <br /> f 7/16/2015 <br /> Office of the County Attorney ' Date: <br /> 4035CB8304CA4A9... <br /> Clerk to the Board <br /> Received for record retention: <br /> Office of the Clerk to the Board Date: <br /> Revised 7114 4 <br />