R 2015-364-E DSS - Senior Care of Orange County, Inc. - provide Adult Day Health Services to OC DSS clients

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DocuSign Envelope ID: EAAlB08E-4226-45A4-818B-A35B979DD90C ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Senior Care of Orange County,, Inc. Party/Vendor Contact Person: Alvonia Baldwin Contact Phone: L219).245-2017 Party/Vendor Address: PO Box 8181 City Hillsborough State: NC Zip: 27278 Department: DSS Amount: $20,000 Purpose: Provide Adult Day Health Services to OCDSS clients Budget Code(s): 10405020-764100 Vendor# Soltvs52717 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one)New ❑ Renewal ® Amendment ❑ Effective Date 07/01/15 Approved by Board Yes®No[] Agenda Date: This agreement is approved as to technical form and Di4e?Signed by: NAAn.CI� �,OStbIA' 7/24/2015 Department Director's Signature Date: BPE1�1-9C,482B4F6... Information Technologies (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer Date: Risk Management This agreement is approved for sufficiency of insur &J wA' 6 y:'specifications, and requirements: Qusa, 66Vlit Office of the Risk Management Officer �ee�s-r�aeaa$ Date: 7/19/2015 Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: DocuSigned by: Office of the Chief Financial Officer INAL [,al 6VU Date: 7/24/2015 Legal Services This agreement is approved as to legal form and rd by: Office of the County Attorney � 1� Date: 7/28/2015 Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dollovd c orangecountyne.gov The following signature block is for hard copies only and is not required for Docusign contracts: