R 2013-426 Attorney - NC League of Municipalities & NCACC for HIPPA and HITECH Compliances with debt setoff

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ORANGE COUNTY-CONTRACT CONTROL SHEET Routing Order: (1)Department,(2)IT,(3)Risk Management,(4)Financial Services,(5)Attorney,(6)Manager,(7)Clerk This Document shall accompany all contracts and shall be submitted for signature in the Routing Order specified above. If the Manager determines the contract is not appropriate for Manager approval the Manager shall submit the contract for BOCC approval. Contracts for BOCC approval must be submitted through,and complete,the routing process prior to agenda review. Contracts for legal review should be completed through the legal review process prior to being routed for signature. Department Party/Vendor Name: NC League of Municipalities&NCACC Party/Vendor Contact Person: Lisa Nolen Contact Phone: 919.715.4362 Party/Vendor Address: 215 N. Dawson St. City Raleigh State:NC Zip:27603 Department: County Attorney Amount: Purpose: HIPPA and HITECH compliance with debt setoff Budget Code(s): Vendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New ❑ Renewal❑ Amendment ❑ Effective Date Approved by Board Yes❑No❑ Agenda Date: Title of Contract: Business Associate Agreement If this is a Grant Agreement,pre-application has been approved by the Board of Commissioners Yes❑No❑. If submitted for bid were bids/RFPs received Yes❑No❑ Bid/RFP number This contract has been reviewed and approved by the Department Director as to technical content: p Department Director's Signature: Date: lo— O IT Director (Applicable only to hardware/software purchases or related services)This contract has been reviewed and approved by the Information Technology Director as to technical content and information technology specifications: IT Director's Signature: Date: I isk Management Include the following coverages: ❑ CGL; ❑ Auto; , ❑ Professional; ❑ Property; OR No Insurance Required ❑. Hold Contract pending receipt of Certificate of Insurance ❑. With incorporation of surance provisions as shown, this c ntract is approved by the Risk Manager: n'(-er•-�^� GL � Risk Manager's Signature: �li�_ /� Date: / 10[8 Financial Services This Contract is conditioned on appropriation by the Board of Commissioners Yes❑ ❑i No / A budget amendment is necessary before approval Yes❑No[�If budget amendment is necessary, please attach to this form. This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Financial Services Director's Signature: �1.tiG'�.��✓ !/ ��'�'`� Date: 1011 ,4112 1011 County Attorney Approval by Board ❑ (Contracts $90,000.00 or more for goods or services, $250,000.00 or more for construction, or any BOCC consultant contract). Approvalk Manager b] (Most other contracts$1,000 and above). Department Director approval only ❑ (Under $1,000). This contract has be r iewe pproved by the Attorney as to legal form and sufficiency: Attorney's Signature Date: County Manager This contract has been reviewed and is ap rove by the County Manager Yes[ Io❑. This contract has been reviewed is s' ture ZrNoFl. Manager's Signature: Date: d Clerk to the Board Approved by BOCC on the day of 20 . Submitted for Chair signature on the_day of 20 Clerk's Signature: Date: Revised March 2012