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Contract #68-2095 <br /> Charles House Association <br />Contract-General (04/23) Page 5 of 5 <br />ORANGE COUNTY—INTERNAL USE ONLY <br />______________________________________________________________________________ <br />Finance Information <br />Vendor Name: Charles House Association Vendor Contact Person: Dean Fox Phone: 919-967-7570 Address: 7511 Sunrise Rd <br />City Chapel Hill State: NC Zip: 27514 Department: Social Services/Aging Amount: $56,000 Purpose: adult day care Budget <br />Code(s): 10405020-764100/10405020-764101/10432020-630100/10432020-630105 Vendor # 19446 <br />Vendor Status with NCSOS: Current-Active is a BOCC consultant: Yes No <br /> <br />Contract Details <br />Contract Type: New Amendment (Original Contract: ) (Most Recent Amendment ) <br />Effective Date 7/1/24 End Date 6/30/25 Notice Date (Notice Purpose ) <br /> <br />Award <br /> Approved by Board (Agenda Date: ); Made or Administered by Nancy Coston & Janice Tyler <br /> <br />Signature Authority <br />- BOCC Express Delegation (Agenda Date: ) <br />- Policy 9.4: Under $5,000; Service Under $90,000; Construction Under $250,000 <br />- Budget Policy Section XV (Capital Improvement Project: ) <br /> <br />Bidding <br /> Informal Bidding ($30k-$90k); Formal RFP ($90k+); Other (<$30k); Exception(# ) <br />Department Affirmation <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project <br />has not been initiated prior to execution of the agreement. <br /> Services related to this agreement have already begun or been completed. Description of the nature of the emergency condition that <br />was addressed: <br /> <br />Department Director’s Signature ________________________________________ Date: ________ <br /> <br />Department Director’s Signature ________________________________________ Date: ________ <br /> <br />Information Technologies <br />This agreement has been reviewed and is approved as to information technology content and specifications: <br /> <br />Office of the Chief Information Officer___________________________________ Date: ________ <br /> Inapplicable because no hardware/software purchases or related services <br /> <br />Risk Management <br />This agreement is approved for sufficiency of insurance standards, specifications, and requirements: <br /> <br />Office of the Risk Management Officer___________________________________ Date: _________ <br /> <br />Financial Services <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br /> <br />Legal Services <br />This agreement is approved as to legal form and sufficiency: <br /> <br />Office of the County Attorney __________________________________________Date: ________ <br /> <br />Clerk to the Board <br />All Docusign contracts must be copied to the Clerk upon completion: occlerkdocs@orangecountync.gov <br />The following signature block is for hard copies only and is not required for Docusign contracts: <br />Received for record retention: <br />Office of the Clerk to the Board __________________________________________Date:_________ <br /> <br /> <br />Docusign Envelope ID: 16F896C3-665C-42FC-B304-EEFEBB208803 <br />6/28/2024 <br />7/1/2024 <br />7/12/2024 <br />7/22/2024 <br />7/25/2024