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,2,d(7 - 09 l <br /> ORANGE COUNTY---DEPARTMENT USE ONLY---HARD COPY ONLY <br /> Department <br /> Party/Vendor Name: Triangle I Council of Governments Party/Vendor Contact Person: Mary Warren Contact <br /> Phone: 919-588-2707 Party/Vendor Address: 4307 Emperor Blvd., Ste 110 City Durham State: NC Zip: 27703 <br /> Department: Aging Amount: $592,820 Purpose: Home and Commun4j Care Block Grant Budget Code(s): <br /> 104301, 20, 50 Vendor# 5855 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract <br /> Type: (Check one)New❑ Renewal® Amendment ❑ Effective Date 07/01/2016 Approved by Board Yes® <br /> Nor] Agenda Date:06/21/16 <br /> This agreement is approved as to technical form and content: <br /> Department Director's Signature Date: <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 /> Office of Risk Management Date:- � <br /> Financial Services <br /> This instrument has been pre-audited in the in er re d by th Local Government Budget and Fiscal Control <br /> Act: <br /> Office of the Chief Financial Officer Date: Z Z <br /> Leeal Services <br /> This agreement is approved as to legal f and s i cy: <br /> Office of the County Attorney Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> Office of the Clerk to the Board —Date: -7 <br /> Revised 2/17 <br />