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This Agreement will be effective on April 21 , 2020 (the date the Agreement is approved by <br />the Indian River County Board of County Commissioners, which is the Effective Date of the Agreement). <br />OWNER: <br />G <br />APPROVED AS TO FORM AND LEGAL SUFFICIENCY: <br />By: —T <br />DyleReingold, County Attorney <br />Jeffrey R. Smith, Clerk of Court and Comptroller <br />Attest'" "�� <br />Deputy Clerk <br />(SEAL) <br />Designated Representative: <br />Name: <br />Title: <br />Address: <br />Phone <br />Email <br />0 <br />PROVIDER: <br />Creative Solutions Companion Care Se e, LLC <br />By: <br />(rovideri V) <br />(CORPORATE SEAL) - <br />Attest <br />Address forgiving notices: <br />License No.-3�2Ik,:s3q <br />(Where applicable) <br />Agent for service of process: (A f <br />Designated Representative: <br />Name: <br />Title: L- k - y <br />Address: <br />S' *L y bcctU <br />e_st 00rne <br />Phone: r -11 3 <br />Email: pkv <br />(If PROVIDER is a corporation or a partnership, attach <br />evidence of authority to sign.) <br />