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DocuSign Envelope ID:23F621AB-7298-4E36-B826-B670C6D009B1 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> PartylVendor Name: fto Homecare Staffing, Inc. Party/Vendor Contact Person: Lesa Kendrick Contact <br /> Phone: 919-732-4663 Party/Vendor Address: 6720 Pentecost Road City Cedar Grove State: NC Zip: 27231 <br /> Department: Social Services Amount: 10,00 Purpose:M Services Budget Code(s): 10400220-622000 Vendor <br /> #59793 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one)New <br /> ❑ Renewal ® Amendment ❑ Effective Date July 1, 2018 Approved by Board Yes❑ No® Agenda <br /> Date: <br /> This agreement is approved as to to Uocusigned by: tent: <br /> NAA�G►� �bSl'bGt. 7/16/2019 <br /> Department Director's Signature 11E1El98A83B455 Date: <br /> Information Technologies <br /> (Applicable only to hardwarelsoflware 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 Manaegment <br /> This agreement is approved for sufficienc QocuSigned by: rds,specifications,and requirements: <br /> Q�Sa L,vV1A.tr�b 7/3/2019 <br /> Office of the Risk Management Offi.Ce 7FDCF0176800498. Date; <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: Docusigned by: <br /> 1 41 .4/� 7/16/2019 <br /> Office of the Chief Financial Officer ` NE5181ACC1409. Date: <br /> Legal Services <br /> This agreement is approved as t Docusigned by: ncy: <br /> 7/16/2019 <br /> Office of the County Attorney 4035CB8304CA4A9 Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloy�orangecountync, oy <br /> The following signature block is for hard copies only and is not required for Docusiga contracts: <br /> Office of the Clerk to the Board Date: <br /> Revised 10/17 <br /> 9 <br />