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DocuSign Envelope ID: FBCC2048-2774-4750-9EA4-440DA53C487A <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Personalized Patient Home Assistance Inc. Party/Vendor Contact Person: Dorothea Farrington Contact <br /> Phone: 919-929-4943 Party/Vendor Address: 109 Concord Drive City: Chapel Hill State: NC Zip: 27516 Department: Social <br /> Services Amount: $415,647/$75,000 Purpose: In-home aides services Budget Code(s). 10400220-630000/10400220- <br /> 680026110432020-630100/10432020-630105 Vendor 9 13754 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No® <br /> Contract Type:(Check one)New❑ Renewal❑ Amendment ® Effective Date May 20,2019 Approved by Board Yes❑No❑ <br /> Agenda Date: <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has <br /> not been initiated prior to executionDocusigned by: <br /> N � ('6� n. 7/19/2019 <br /> Department Director's Signature h�ocusigned by: Date: <br /> Department Director's Signature g7E902D1BF454=A.. Date. 7/19/2019 <br /> Agreements for emergency services or repair are not subject to the above affirmation. If services related to this agreement have <br /> already begun or been completed please briefly describe the nature of the emergency condition that was addressed: <br /> Information Technologies <br /> (Applicable only to hardwarelsoftware purchases or related services)This agreement has been reviewed and is approved as to <br /> information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Manaeemient <br /> This agreement is approved for sufficient Qocusignea by: ` ' ids,specifications,and requirements. <br /> aUSA c4VIA.t& 6/14/2019 <br /> Office of the Risk Management Office 7FDCF9176800408. Date: <br /> Financial Services <br /> This instrument has been pre-audited it oocusigned by: the Local Government Budget and Fiscal Control Act: <br /> ('q� 0." � 7/19/2019 <br /> Office of the Chief Financial Officer 7o4E15181ACC1409. Date: <br /> Le al Services <br /> This agreement is approved as ti D cuSigned by:' r ncy: <br /> Office of the County Attorney � �,•4"" _ Date: 7/19/2019 <br /> 4035Cg8304CA4M <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@orangecount)mc.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 12118 <br />