HomeMy WebLinkAboutR 2015-286-E Aging - Jennifer Sugg, RN for wellness instructor DocuSign Envelope ID:84D563A0-30F8-4571-947C-73CC853AB58C
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Jennifer Sum, R.N. Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: P O Box 272 City Bynum State: NC Zip: 27228 Department:Aging Amount: $5.000.00 Purpose:wellness
instructor Budget Code(s): 29430320-622000 Vendor 4 63091 (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:
WcuSigned by:
Department Director's Signature s Tt by Date: 6/24/2015
UE902D1BF454FA...
Information Technolouies
(Applicable only to ha7rdwa7re/sofhva7re 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 irnurnnce,tandards, specifications, and requirements:
Wousigned by:
Office of the Risk Management Officer U501 (h1 6 Date: 6/24/2015
7FDCF9176800408...
Financial Services
This instrument has been pre-audited in*n°oaciasi�ned bx: ;—A 1the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer 6vu Date: 6/24/2015
2326FFC2CFA847B...
Leual Services
This agreement is approved as to le--'
g PP OocuSigned by:
Office of the County Attorney ?�'^ '•�"h- Date: 6/25/2015
4035CB8304CA4M...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dsrlisr, d ,eotylic, )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