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DocuSign Envelope ID:75C616E5-76E4-43AA-986C-053F34F85F83 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Happy Homecare Staffing, Inc, Party/Vendor Contact Person: Lesa Kendrick Contact <br /> Phone: 919-732-4663 PartylVendor Address: 6720 Pentecost Road City Cedar Grove State: NC Zip: 27231 <br /> Department: Social Services Amount;$10,000 Purpose: RN Services Budget Code(s): 10400220-622000 Vendor <br /> 4 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, 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 <br /> on this project has not been initiated prior to execution of the agreement: <br /> DocuSigned by: <br /> Department Director's Signature �bSf b5 Date: 9/17/2019 <br /> DAE1E198A83B455 . <br /> Agreements for emergency services or repair are not subject to the above affirmation. If services related to this <br /> agreement have already begun or been completed please briefly describe the nature of the emergency condition that <br /> was addressed: <br /> Information Technologies <br /> (Applicable only to hardwarelsoftware 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 Management <br /> This agreement is approved for sufficien( Qocusigned by: irds,specifications,and requirements: <br /> Q�Sa �,DV1A.tr�b 9/17/2019 <br /> Office Of the Risk Management Office 7FDCF0176800408. 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 /> lr7NE5181ACC1409 <br /> J 4 � 9/17/2019 <br /> Office of the Chief Financial Officer Date: <br /> . <br /> Legal Services <br /> This agreement is approved as tiE41035CB8'304C'A4Ae <br /> - Docusigned by:" - ncy: <br /> Office of the County Attorney '" �' Inv.__ Date: 9/17/2019 <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@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 6/19 <br /> 9 <br />