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HomeMy WebLinkAboutR 2019-272 DSS - Orange Public Transportation MOU for Medicaid transportation DocuSign Envelope ID:527817D2-A523-467C-9535-4049B100BOE1 ORANGE COUNTY---DEPARTMENT USE ONLY Department Party/Vendor Name: Orange County Public Transit Party/Vendor Contact Person: Theo Letman Contact Phone: (919) 245-2007 Party/Vendor Address: PO Box 8181 City Hillsborough State: NC Zip: 27278 Department: Social Services Amount: N/A-State 12gvs directly. Purpose: Nan-Emergency Medicaid Transportation Budget Code(s): NIA-State pays directly. Vendor #:NIA (NIA if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: {Check one} New ❑ Renewal ® Amendment ❑ Effective Date July 1. 2018 Approved by Board YesL No® Agenda Date: This agreement is approved as to tec oocu5igned by: ent: �bSbtn 5/8/2019 Department Director's Signature Date: SAP E198A83B455 Information Technologies (Applicable only to hardwareAsaftware 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 fc----mac,-si­gned ay:'`----ance standards,specifications,and requirements- 1 7F©CF917E8 0040049 8.USA Office of Risk Management_ �,DV Date; 5/8/2019 Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Docu5igned by: 5/9/2019 Office of the Chief Financial Officer 7�4E51s1ACC1409. Date: Legal Services This agreement is approved as tc - oocuSigned by: ncy: Office of the County Attorney �-ht_�, '°y' - Date: 5/9/2019 4035CB8304CA4M Clerk to the Board Received for record retention: Office of the Clerk to the Board Date: 5