HomeMy WebLinkAboutR 2016-310 Aging - Triangle J COG Area Agency on Aging for Medicare Improvements for Patients and Providers Act (MIPPA) ORANGE COUNTY-DEPARTMENT USE ONLY I r _ 2 ) O
Department �/ J!
Party/Vendor Name: Triangle J Council of Governments Area Agency on Aging_(TJAAA) Party/Vendor Contact
Person: Mary Warren Contact Phone: 919-558-2707 Party/Vendor Address: 4307 Emperor Blvd., Ste 110 City
Durham State:NC Zip:27703 Department:Aging Amount: $3,500 Purpose:Medicare Improvements for Patients
and Providers Act(MIPPA) Budget Code(s): 10432005-444128v#endor#5855 (N/A if new vendor) Vendor is
a BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New❑ Renewal Z Amendment ❑ Effective
Date 10101115 Approved by Board Yes❑Non Agenda Date:
This agreement is approved as to technical form and content:
Department Director's Signature Date: —_6
Information Technologies
(Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is
approved as to information technology content and specifications:
Office of the Director of Information Technology Date:
Risk Management
This agreement is approved for sufficiency of insurance standards,specifications,and requirements:
Office of Risk Management�I L '4 Date 6
Financial Services
This instrument has been pre-audited in the anne equir by the Local Government Budget and Fiscal Control
Act:
Office of the Chief Financial Officer Date: 2-3
Legal Services
This agreement is approved as to legal fo d su iency:
Office of the County Attorney Date: f7
Clerk to the Board
Received for record retention:
Office of the Clerk to the Board Date: