Orange County NC Website
Browse       Search
4 <br />ORANGE COUNTY <br />INSTITUTIONAL RESPITE <br />PROVIDER AGREEMENT <br />This is to certify that <br />(Name of Agency) <br />heirein after known as the Provider agency, located at <br />(Address) <br />on this first day of July, 1992 agrees to participate as a provider in <br />the Orange County Elderly Respite Care Program for the period July 1, <br />1992 through June 30, 1993. <br />1. The Provider agency agrees to provide necessary Institutional <br />Respite Day Care to approved recipients at a rate not to exceed <br />$30.00 per eight hour day upon the request of the Orange County <br />Department on Aging's Care Management Program, hereinafter known <br />as the lead Administrative Agency. <br />2. The Provider agency agrees to meet all service provision <br />standards for Institutional Respite Day Care, such as training as <br />required by the State of North Carolina and provide documentation <br />upon request. (Attachment A) <br />3. The provider agency agrees to provide the Institutional Respite <br />Day Care within ten working days from the beginning service date <br />specified in the Purchase of Service Authorization on each <br />approved recipient. (Attachment B) <br />4. The provider agency agrees to ensure that such records as <br />necessary are kept to fully disclose the extent of the service <br />provided to recipients for four years and available for <br />inspection. <br />5. The Provider agency agrees to submit a monthly bill for services <br />rendered payable within 30 days from date of receipt. <br />6. The Provider agency agrees to adhere to the Inter- Agency Long Term <br />Care Management Procedures in the provision of the service. <br />(Attachment C) <br />7. The Provider agrees to indemnify and save harmless Orange County, <br />its agents and employees from and against any and-all loss, cost, <br />damages, expense and liability caused by the failure of the <br />Provider to fully perform its obligations under this agreement and <br />in accordance with its terms; or by an accident or other <br />occurrence causing bodily injury, including death, sickness, <br />products or services rendered under this Agreement. <br />Provider shall maintain general liability insurance with limits no <br />less than $100,000 /occurrence. Certificates of Insurance <br />reflecting such coverage must be furnished to Orange County and <br />shall contain the provision that Orange County will be given <br />thirty days written notice of any intent to amend or terminate <br />such policies by either the Provider or the insuring company. <br />