HomeMy WebLinkAboutR 2017-121 Aging - Triangle J Council of Governments Area Agency on Aging fo MIPPA/SHIIP Outreach ORANGE COUNTY---DEPARTMENT USE ONLY---HARD COPY ONLY
Department
Party/Vendor Name: Triangle J Council of Governments Area Agency on Aging Party/Vendor Contact Person:
Mary Warren Contact Phone: 919-558-2707 Party/Vendor Address: 4307 Emperor Blvd., Ste. 110 City Durham(1�
State: NC Zip: 27703 Department: Arming Amount: $3,500 Purpose: MIPPA/SHIIP Outreach Budget Code(s):',{CxJ` -
10432005-444128 Vendor#5855 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No[:] Contractl_
Type: (Check one)New❑ Renewal® Amendment ❑ Effective Date 10/01/2016 Approved by Board Yes❑
Nor-1 Agenda Date:
This agreement is approved as to technical form and content:
Department Director's Signature Date: -mss
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 Chief Information Officer Date:
Risk Management
This agreement is approved for sufficiency of insurance standards,specifications,and requirements:
Office of Risk Management �(.L�=— j-0 Date:_*_Vh 7
inanciaJ Services
This instrument has been pre-audited in the ner r uii ed the Local Government Budget and Fiscal Control
Act:
Office of the Chief Financial Officer A Date: 7
7 Legal Services
This agreement is approved as to leg fo s iciency:
Office of the County Attorney' Date: d 1�
Clerk to the Board
Received for record retention:
Office of the Clerk to the Board Date:
Revised 2/17