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DocuSign Envelope ID: DBC2D3D5-DDD6-4D1 D-8ED6-DFMBF2132278 <br /> GRANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name; Flaircare Inc. dba Homewatch Caregivers of the Triangle Party/Vendor Contact Person: Anzor Gachechiladze <br /> Contact Phone: Party/Vendor Address: 1210 SE Maynard Road City: CM State: NC Zip: 27511 Department: 5qgW <br /> Services Amount: $415,647/$75,000 Purpose: In-home aides services Budget Code(s): I0400220-630000/10400220- <br /> 680026/10432020-630100/10432020-630105 Vendor#53657 (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 execution - Docusigned by: <br /> �Na1n,Gy 1✓6S�btn 7/22/2019 <br /> Department Director's Signature DB7E062D1BF454'=A. <br /> QocuSigned by Date <br /> �iu- - ��k 7/24/2019 <br /> Department Director's Signature Date: <br /> . <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 Technoloeies <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 Management <br /> This agreement is approved for sufficient Qocusigned by: rds,specifications,and requirements: <br /> Q�Sa L.Qw�f�b 7/19/2019 <br /> Office of the Risk Management Office 7FDCF0176800408. Date_ — <br /> Financial Services <br /> This instrument has been pre-audited v vocusigned by: the Local Government Budget and Fiscal Control Act: <br /> rq � � 7/25/2019 <br /> Office of the Chief Financial Officer 7D4E51s1ACC140s. Date: <br /> Legal Services <br /> This agreement is approved as to DocuSigned by: icy: <br /> _�l,h�-{r�j, �.,nnh_ <br /> Office of the County Attorney- gp35C@8304CA4A� Date;7/25/2019 <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: snngersoll@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 12118 <br />