R 2016-501-E Aging - A Helping Hand for in-home services (2)

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DocuSign Envelope ID:2AFB7829-0884-48C4-969F-481222A1BCE1 ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: A Helping Hand Party/Vendor Contact Person: Jennifer Ashlev Contact Phone: 919-403-5555 Party/Vendor Address: 1502 W NC Hwy 54, Ste 405 City Durham State: NC Zip: 27707 Department: Agin Amount: $14,280 Purpose: in-home services Budget Code(s): 10432020-630105 Vendor # 32018 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No[] Contract Type: (Check one) New ❑ Renewal Amendment ❑ Effective Date Approved by Board Yes❑No❑ Agenda Date: This agreement is approved as to tec7i ,,f9WQd content: �icc' �` Department Director's Signature Date: 8/30/2016 67E962D18F454FA... Information Technolosies (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 insurance standards, specifications,and requirements: Docu5igned by: Office of the Risk Management Officer USA. (,6nAA 111i 6 Date: 8/30/2016 7FDCF9176800498... Financial Services This instrument has been pre-audited in the 0 u nenre squired by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer (� `�°'�" °'v Date: 8/30/2016 7D4E5181ACC1409... Legal Services This agreement is approved as to legal form and sufficiency: DocuSigned by: Office of the County Attorney Date: 9/1/2016 4035CE8304CA4A9... Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloy(d c�orangecount.nic.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board Date: Revised 6/16 5