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Aolq - �� <br /> ORANGE COUN'T'Y---DEPART'MEN'T' USE ONLY---HARD COPY ONLY <br /> Department <br /> Party/Vendor Name: Missouri Community Action Network Party/Vendor Contact Person: Customer Service <br /> Contact Phone: 573-634-2969 Party/Vendor Address: 2014 William Street City Jefferson City State: MO Zip: <br /> 65109 Department: Health Amount: $2,150 Purpose: Poverty simulation license Budget Code(s): 10412020- <br /> 680007-71451 Vendor #N/A (N/A if new vender) Vendor is a BOCC consultant? Yes ❑ No X Contract <br /> Type: (Check one)New X Renewal❑ Amendment ❑ Effective Date 11-9-17 Approved by Board Yes❑No <br /> ❑ Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> Department Director's Signature Date: 0 <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 /> i <br /> Office of Risk Management Date: l 7 <br /> Financial Services <br /> This instrument has been pre-audited in the a r Ldby Local Government Budget and Fiscal Control <br /> Act: f <br /> d <br /> Office of the Chief Financial Officer Date: "74; 7 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Office of the County Attorney 6.�/ !y r <br /> <<J4•L Date: W i 1 11-1 <br /> Clerk to the Board <br /> Received for record retention: <br /> Office of the Clerk to the Board Date: <br /> Revised 2/17 bt%ck 4-t, 1)ef 2,11 <br /> ��r <br />