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DocuSign Envelope ID:4FFDF545-B8C1-4ABF-A6A5-400656A36357 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Senior Care of Orange County, Inc Party/Vendor Contact Person: Alvonia Baldwin Contact <br /> Phone: 919-245-2017 Party/Vendor Address: 105 Meadowland Drive City Hillsborough State: NC Zip: 27278 <br /> Department: Finance & Administrative Services Amount: 30000 Purpose: Outside Agencies Funding Budget <br /> Code(s): 10495050-719027 Vendor# 800047 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ <br /> Contract Type: (Check one)New® Renewal❑ Amendment ❑ Effective Date 7/1/16 Approved by Board Yes <br /> ®Nor-1 Agenda Date: 6/21/16 <br /> This agreement is approved as to technical form and efttWSigned by: <br /> Department Director's Signature t� nnG�, Date: <br /> Information Technolo0es <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 ins ur ®mot lords, specifications,and requirements: <br /> Qusa. COV'lnd 6 <br /> Office of the Risk Management Officer Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner r Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer 7 Date: <br /> �B&Er1S4RCG 1409... <br /> Legal Services <br /> This agreement is approved as to legal form and su yS geed by: <br /> Office of the County Attorney ff 4 1`� Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydkorangecount.nic.gov <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> Office of the Clerk to the Board Date: <br /> (Senior Care of Orange County,Inc) <br /> Orange County Outside Agency Performance Agreement <br /> Rev. 8116 <br />