HomeMy WebLinkAboutR 2017-632-E Finance - MAXIMUS - Consultant for Cost Allocation Plan, EMS Medicaid Cost Report DocuSign Envelope ID:54B16D7E-C063-4FF1-B6ED-4F40C221096B
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: MAXIMUS Consulting Services Inc. Party/Vendor Contact Person: Jason Jennings
Contact Phone: 804-323-3535 Party/Vendor Address: 808 Moorefield Park Drive, Suite A, Richmond, VA,
23236 Department: Finance & Administrative Services Amount: $27,900 ($8,300 Cost Plan (FY2017, FY2018,
FY2019 and$1,000 EMS Report (FY2017, FY 2018,FY2019)))Purpose: Consultant for Cost Allocation Plan and
EMS Medicaid Cost Report over the next 3 fiscal years Contract Budget Code(s): 10230020 630000—Finance and
Administrative Services Contract Services Vendor# (N/A if new vendor): 5730 Vendor is a BOCC consultant?
Yes ❑No Contract Type: (Check one)New® Renewal ❑ Amendment ❑
Effective Date:N/A Approved by Board: Yes No Agenda Date: N/A
This agreement is approved as to technical f rm` t 6t�'rit:
0,44. 1.00x. 10/31/2017
Department Director's Signature m481ACC14n9 Date:
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 -:saw standards,specifications, and requirements:
M rbvvutl6 11/15/2017
Office of Risk Management Rsa�6a0e49a Date:
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act: DocuSigned by:
Office of the Chief Financial Officer 7D ��� 10/31/2017
7DaE5�81 ACC�aQ9 Date:
Legal Services
This agreement is approved as to legal form Re i gty:
joLvi, t°blit,viS 11/22/2017
Office of the County Attorney
EaAaa : .,
Clerk to the Board
Received for record retention:
Office of the Clerk to the Board Date: