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� <br /> DocuSign Envelope ID:9BE92A26-4CEE-4AC3-BC41-BB345E355lA4 <br />| <br /> ORANGE USO8K��iL�r <br />� �� ���� � <br /> Departmen <br /> Party/VendorNune: Personalized Patient Flome Assistance Inc Party/Vendor Contact Person: Dorothy Farrington <br /> Cou(uu Phone: PunyyVcudur /\ddreus: 109 Concord Dr City State: NC Zip: 27516 <br /> I)epartmcotIS%S Amount: $IL.5 J�7 Purpose: In home services to DSS aging clients Budget Code(s): |04{Kll2U- <br /> 630080 Vendor # f new vendor) Vendor ina08CC consultant? Yem E] NuO Contract <br /> (Check one) New F Renen/a/ F� y`mcu6mcot |; Effective Date 87/0l/|6 Approved 6yBoard YeePINo[] <br /> Agenda Date:____ <br /> This agreement iuupprmvedux|utechnical fo <br /> Department Director's Signature Date: 7/14/2016 <br /> Information Technologies <br /> (Applicahle on4,to hardwarelsoftware purchases or related services)This agreement has been reviewed and is <br /> approved o»to information technology content and specifications: <br /> Office wf the Director uf Information Tecbuu)ogy 0u1u: ______. <br /> Risk Mana2ement <br /> This agreement imupprovedfbrmu[G6encyo[iosuru mkauidw.�i iG a1i and requirements: <br /> Office of Risk Management Date: 7/11/2016 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: u"""mn""o»': <br /> ��f�rmaf the^�hiufFinancial��y�«er � «~ Date: 7/14/2016 <br /> Le2al Services! <br /> This agreement ia approved ueio legal form and suUSui o:ocuSig I ned^ <br /> 7/18/2016 <br /> Office otthe County Attorney 4035oa8304C^4A9 <br /> Qme:_______ <br /> Clerk to the Board <br /> Received for record retention: <br /> Office oY the Clerk tothe Board <br /> _ <br />