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DocuSign Envelope ID:4ED1919B-8BFA-4385-BOCC-6310D35F6154 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Happy Homecare Staffing, Inc. Party/Vendor Contact Person: Lesa Kendrick Contact Phone: <br /> 919-732-4663 Party/Vendor Address: 6720 Pentecost Road City Cedar Grove State: NC Zip: 27231 Department: <br /> Social Services Amount: $10,000 Purpose: RN Services Budget Code(s): 10400220-630000 Vendor#59793 (N/A if <br /> new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ❑ Renewal <br /> Amendment ❑ Effective Date July 1,2017 Approved by Board Yes No Agenda Date: <br /> This agreement is approved as to to 'eatittmiditvid content: <br /> NAtn,(1 ( sfet& 9/1/2017 <br /> Department Director's Signature QAE,�19€AeaB455 Date: <br /> Information Technologies <br /> i <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: j <br /> Office of the Chief Information Officer Date: <br /> i <br /> 1 <br /> Risk Management <br /> i d �' <br /> This agreement is approved for sufficien o ficg'st ndards,specifications,and requirements: <br /> �lSae0 8/31/2017 <br /> Office of the Risk Management Officer 7FDCF917680o498... Date: <br /> Financial Services �I <br /> This instrument has been pre-audited ' t eihugtl W1equired by the Local Government Budget and Fiscal Control Act: <br /> ( '6°,1.4t i'"°� 9/1/2017 <br /> Office of the Chief Financial Officer 7D4E5181ACC1409. Date: <br /> Legal Services <br /> This agreement is approved as t eg rtaiTifaa_W'd sufficiency: <br /> - Date: 9/5/2017 <br /> Office of the County Attorney 4o35C B8304CA4A9.. <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd a,orangecountync.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 /> Revised 6/16 5 <br />