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DocuSign Envelope ID: 147BE359-9EE3-4364-92AB-6619CE690DOB <br /> GRANGE COUNTY DEPARTMENT USE ONLY <br /> Party/Vendor Name: Premier Home Health Care Services, Inc. Patty/Vendor Contact Person: Grego GregoEy Turchan Contact Phone: <br /> 919-428-7722 PartylVendor Address:445 Hamilton Avenue City: White Plains State: NY Zip: 10601 Department: Social Services <br /> Amount: $610.647/$75.000 Purpose: In-home aides services Budget Code(s): 10400220-630000/10400220-680026/10432020- <br /> 630100/10432020-630105 Vendor 9 4543 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: <br /> (Check one)New ❑ Renewal ❑ Amendment ® Effective Date May 20, 2019 Approved by Board Yes❑No{] Agenda <br /> 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 executio DocuSigned by: <br /> 7�" (, Sf bvu 7/24/2019 <br /> Department Director's Signature QocuSlgned by: Date: <br /> cI.I tu_ -�bw 7/24/2019 <br /> Department Director's Signature[B7E,,2D1BF454=A.. Date: <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 Management <br /> This agreement is approved for suf icienc Qocusigned by:-`--'-rds,specifications,and requirements: <br /> QUs& c4VIA.t 6 7/10/2019 <br /> Office of the Risk Management Office 7FDCF9,76800498. Date: <br /> Financial Services <br /> This instrument has been pre-audited nE <br /> cusigned by: the Local Government Budget and Fiscal Control Act: <br /> O � 7/25/2019 <br /> Office of the Chief Financial Office4E5181ACC1409. Date: <br /> Legal Services <br /> This agreement is approved as tCL)ocuSigned by: ncy: 7/25/2019 <br /> Office of the County Attorney4035CB8304CA4M Da#e; <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@orangecountyne.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 12/18 <br />