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DocuSign Envelope ID:9F8945D7-E616-45A2-816D-12F64FB659FF <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Senior Care of Orange Party/Vendor Contact Person: Katie Garvey Contact Phone: <br /> Party/Vendor Address: 105 Meadowlands Drive City Hillsborough State: NC Zip: 27278 Department: Aging <br /> Amount: $8000.00 Purpose: Adult Day care Budget Code(s): 10432020-630100 and 630105 Vendor # 800047 <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ <br /> Renewal® Amendment ❑ Effective Date Approved by Board Yes❑No❑ Agenda 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 J Date: 10 26 2021 <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 hardware/software 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 sufficienc ma*sroaamtandards,specifications,and requirements: <br /> &A, Chnt,t,11b 10/26/2021 <br /> Office of the Risk Management Officer 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 /> rI 0..Zw7, 1012712021 <br /> Office of the Chief Financial Officer Date: <br /> Legal Services <br /> This agreement is approved as to PfMWOWsufficiyeenc�y: <br /> Office of the County Attorney 0 -" Date: 11/3/2021 <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 12/18 <br /> 8 <br />