HomeMy WebLinkAboutR 2015-280-E Aging - Sarah Benedict for wellness instructor DocuSign Envelope ID: 5C4F3E91-6CBB-4EE5-8507-23A674D21410
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Sarah Benedict Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 302 Waterside Drive City Carrboro State:NC Zip:27510 Department: Aging Amount: $4,000.00 Purpose:
wellness instructor Budget Code(s): 29430320-630000 Vendor 4 38196 (N/A if new vendor) Vendor is a BOCC
consultant? Yes ❑No® Contract Type: (Check one)New ❑ Renewal ❑ Amendment ❑ Effective Date July 1,
2015 Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to technical form and content:
DocuSigned by:
Department Director's Signature [_,� U_ - �x Date: 6/22/2015
B7E962D1BF454FA...
Information Technologies
(Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is
approved as to information technology content and specifications:
Office of the Chief Information Officer Date:
Risk Management
This agreement is approved for sufficiency of insurance standards,specifications,and requirements:
DocuSigned""by:
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Office of the Risk Management Officer allStU (hVV,&b Date:6/23/2015
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in .BM „�6d-gffuired by the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer PMAL ['"-+6VU Date: 6/23/2015
232DFFC2CFA847B...
Legal Services
This agreement is approved as to legal for gmeaanbd sufficiency:
Office of the County Attorney , 1 Date: 6/23/2015
4035CB83046A4A9...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloyLyorangecou go v
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board Date:
Revised 10/14 4