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DocuSign Envelope ID: 744F8ADB-CD3C-429C-BA9E-C4FEEC31A417 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Deuartment <br /> Party/Vendor Name: MAXIMUS Consulting Services,Inc. Party/Vendor Contact Person: Jason Jennings Contact <br /> Phone: 804-323-3535 Party/Vendor Address: 808 Moorefield Park Dr., Suite 205 City Richmond State:VA Zip: <br /> 23236 Department:Finance and Administrative Services Amount: $27,000.00 Purpose: Development of <br /> Central Services Cost Allocation plan, prepare indirect cost proposals, negotiate with state or federal government, <br /> prepare ES Medicaid cost report Budget Code(s): 10230020-630000 Vendor # (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes ❑ NoX❑ Contract Type: (Check one)New ❑ Renewal ❑ Amendment <br /> ❑ Effective Date Approved by Board Yes❑NoX❑ Agenda Date: <br /> This agreement is approved as to technical fo 6VdGQatgPt: <br /> Department Director's Signature �albin, Date:2/21/2015 <br /> 232DFFC2CFA847B... <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> DocuSigned""by: <br /> ''1L <br /> Q�As& r,6vvt,e b 2/22/2015 <br /> Office of the Risk Management Officer Date: <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: DocuSigned by: <br /> 2/21/2015 <br /> Office of the Chief Financial Officer Ep.,� blti Date: <br /> 232DFFC2CFA847B... <br /> Legal Services <br /> This agreement is approved as to legal form anc�§af�£gr�eggj.y: <br /> Office of the County Attorney , bLvu otxfs Date: 2/23/2015 <br /> EAA3D33ED8A8465... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloyLvorangecoun nc.gov <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br />