R 2017-413-E Aging - Senior Care of Orange County Inc. for adult day health care services

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DocuSign Envelope ID:30CFBA21-DC65-423A-A674-7D24A692C6ED ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Senior Care of Orange County Inc Party/Vendor Contact Person: Swayzene Riggsbee Contact Phone: Party/Vendor Address: 105 Meadowlands Drive City Hillsborough State: NC Zip: 27278 Department: Aging Amount: $6,700 Purpose: adult day health care services Budget Code(s): 10432020-630100 Vendor#800047 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective Date 8/20/17 Approved by Board Yes' No Agenda Date: This agreement is approved as to technical form and content: /^--DocuSigned by: Department Director's Signature ja kAa- � t V Date: 8/24/2017 B7E962D1BF454FA... 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 insurance standards,specifications,and requirements: r---DocuSiggned_by: Office of the Risk Management Officer aMMS& COVln,f ll b Date: 8/25/2017 7FDCF9176800498... Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: -- , —DocuSigned b : Office of the Chief Financial Officer �� Date: 8/25/2017 —7D4E5181 ACC1409... Legal Services This agreement is approved as to legal form and sufficiency: p--DocuSigned by: Office of the County Attorney abUAL hark, -NO Date: 8/25/2017 `—079A4D525C0F4FB... Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd @orangecountync.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 2/17 5