Orange County NC Website
Browse       Search
DocuSign Envelope ID:871596FB-EB3F-4768-BC79-A5D9ADF74E87 <br /> <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Triangle J Council of Governments Area Agency on Aging Party/Vendor Contact Person: Joan <br /> Pellettier Contact Phone: 919.549.0551 Party/Vendor Address:4307 Emperor Blvd, Ste 110 City Durham State:NC <br /> Zip: 27703 Department: Aging Amount:MM Purpose: Medicare Outreach(MIPPA) Budget Code(s): 10432005- <br /> 444128 Vendor#5855 (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No❑ Contract Type:(Check <br /> one) New ❑ Renewal ® Amendment ❑ Effective Date 09/30/2014 Approved by Board Yes❑ No❑ <br /> Agenda Date: <br /> This agreement is approved as to tec ab�iar;lx�sad content: <br /> Department Director's Signature <br /> fiy�l' Date: 4/23/2015 <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 sufficienc bawamestandards,specifications,and requirements: <br /> Q�ISA �,OYVI.I 6 4/24/2015 <br /> Office of the Risk Management Officer Date: <br /> Financial Services <br /> This instrument has been pre-audited in t 4 i ed by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer Date: 4/24/2015 <br /> Legal Services <br /> This agreement is approved as to legal fo ®iafey: <br /> (� 4/28/2015 <br /> Office of the County Attorney rb � Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecoun!ync.gov <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> Office of the Clerk to the Board Date: <br /> Revised 10/14 4 <br />