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DocuSign Envelope ID:89EE68A1-29FA-417C-9C6F-034CDOD2C779 <br /> ORANGE COUNTY--DEPARTMENT USE ONLY <br /> Department <br /> Parry/Vendor Name: KAH Care, L.L.C. dba Right at Home. Party/Vendor Contact Person: Kenneth Helmuth <br /> Contact Phone: (919) 241-5292 Party/Vendor Address: 105 W. Corbin St, Suite 203 City Hillsborough State: NC <br /> Zip: 27278 Department: DSS Amount: $75,000 Purpose: Provide employees to perform in-home services for <br /> OCDSS clients Budget Code(s): 10400220-630000 Vendor ## (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective Date <br /> 07/01/15 Approved by Board Yes®No❑ Agenda Date: <br /> This agreement is approved as to technical form and c �cuSigned by: <br /> Department Director's Signature NAAn.Ct� 4f6vu Date: 7/21/2015 <br /> DRE1�1-9 f J4&3B�55... <br /> Information Technolozies <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 Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insura "%ys'peecifcations,and requirements: <br /> Q�ASA. r,6Vtit,t�b 7/19/2015 <br /> Office of the Risk Management Officer _nr 94zaaL1DAS8... Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: DocuSigne�d,�,b�y:: <br /> r� [A"' 6VU 7/22/2015 <br /> Office of the Chief Financial Officer aeFs�asaz® Date: <br /> Legal Services <br /> This agreement is approved as to legal form an by: <br /> Office of the County Attorney 1 Date: 7/22/2015 <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dollog orangecountync.Mov <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> i <br />