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R 2010-053 DSS - Arcadia in home services
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R 2010-053 DSS - Arcadia in home services
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2010-053 DSS - Arcadia Health Services, Inc. - Service Agreement for In-Home Aide Providers
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\Board of County Commissioners\Contracts and Agreements\General Contracts and Agreements\2010's\2010
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ORANGE COUNTY—CONTRACT CONTROL SHEET <br /> Routing Order: (1)Department,(2)IT,(3)Risk Management,(4)Financial Services,(5)Attorney,(6)Manager,(7)Clerk <br /> This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. If the Manager <br /> determines the contract is not appropriate for Manager approval the Manager shall submit the contract for BOCC approval. Contracts for <br /> BOCC approval must be submitted through,and complete,the routing process prior to agenda review. Contracts for legal review should <br /> be completed through the legal review process prior to being routed for signature. <br /> Department <br /> Party/Vendor Name: Arcadia Party/Vendor Contact Person: Tara Ward Contact Phone: 1-800-733-8427 Party/Vendor Address:26777 <br /> entral Park Blvd City Southfield State:MI Zip: 48076 Department: DSS Amount: Purpose: In home care Budget Code(s): <br /> � Vendor 9 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No❑ Contract Type: (Check one)New❑ <br /> Renewal® Amendment ❑ Effective Date Approved by Board Yes❑No❑ Agenda Date: Title of Contract: In <br /> home care <br /> If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners Yes❑No❑. If submitted for bid were <br /> bids/RFPs received Yes❑No❑ Bid/RFP number This contract has been reviewed and approved by the Department Director as to <br /> technical content: <br /> Department Director's Signature: Date: G O <br /> IT Director <br /> (Applicable only to hardware/software purchases or related services)This contract has been reviewed and approved by the Information <br /> Technology Director as to technical content and information technology specifications: <br /> IT Director's Signature: Date: <br /> Risk Management <br /> Include the following coverages: ❑ CGL; ❑ Auto; ❑ WC; ❑ Professional; ❑ Property; ❑ OR No Insurance Required El. Hold <br /> Contract pending receipt of Certificate of Insurance ❑. With incorporation of Insurance provisions as shown, this contract is approved <br /> by the Risk Manager: <br /> Risk Manager's Signature: Date: <br /> ppe td X12 v/ib <br /> Financial Services <br /> This Contract is conditioned upon appropriation by the Board of Commissioners Yes❑No�W. A budget amendment is necessary <br /> before approval Yes❑NoW. If budget amendment is necessary,please attach to this form. This instrument has been pre-audited in the <br /> manner required by the Local Government Budget and Fiscal Control Act: <br /> Financial Services Director's Signature: Mk.w A Date: 2� <br /> County Attorney <br /> Approval by Board X (Contracts over $90,000.00 for goods or services, $250,000.00 for construction, or any BOCC consultant <br /> contract). Approval by Manager ❑ (All other contracts). This contract has been reviewed and approved by the Attorney as to legal <br /> form and sufficiency: <br /> Attorney's Signature Date: <br /> County Manager <br /> This contract has been reviewed and is approved by the County Manager Yes❑No❑. <br /> This contract has been reviewed and is to be submitted for BOCC consideration Yes❑No❑. <br /> Manager's Signature: Date: <br /> Clerk to the Board <br /> Approved by BOCC on the day of ,2 . Submitted for Chair signature on th day of ,20 <br /> Clerk's Signature: Date: <br /> Revised April 2010 UV <br />
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