HomeMy WebLinkAboutR 2019-149 Aging - MIPPA services contract o Iq
c2 -�
ORANGE COUNTY-DEPARTMENT USE ONLY
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
State : NC Zip : 27703 Department : Aging Amount : $ 3 , 500 Purpose . MIPPA Outreach Budget Code(s) .
10434005 -new Vendor # 5855 (N/A if new vendor) Vendor is a BOCC consultant ? Yes ❑ No ❑ Contract
Type : (Check one) New ❑ Renewal ® Amendment ❑ Effective Date 10/01 /2018 Approved by Board Yes
❑ No ❑ Agenda Date :
This agreement is approved as to technical form and content and I as Department Director affirmatively state work
on this "project has not been initiated prior to execution of the agreement :
Department Director ' s Signature4oeted
- Date . e1 "
Agreements for emergency services not subject to th bove affirmation . If services related to this
agreement have already begun or be please briefly describe the nature of the emergency condition that
was addressed :
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 :
/ .j
Office of the Risk Management Officer L ��_ Date : r . j
Financial , ervices
This instrument has been pre - audited in the in ner red by the Local Government Budget and Fiscal Control ►
Act :
Office of the Chief Financial Officer Date : ���
Legal Services
This agreement is approved as to legal form and sufficiency :
Office of the County Attorney � � f / U�t ! G'd�l,�' Date , 3h2W111i
Clerk to the Board
Received for record retention :
All Docusign contracts must be copied to Sherri Ingersoll upon completion : smgersoll@orangecountync . gov
The following signature block is for hard copies only and is not required for Docusign contracts :
Office of the Clerk to the Board Date :
Revised 12/ 18