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HomeMy WebLinkAboutR 2015-293-E Aging - Toni Shaw for wellness instructor DocuSign Envelope ID:4304A459-1187-466D-BE4D-2222D2FDOB84 ORANGE COUNTY—DEPARTMENT USE ONLY Deuartment Party/Vendor Name: Toni Shaw Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: 1301 Deerfield City Mebane State: NC Zip: 27302 Department: Aging Amount: $800.00 Purpose: Wellness Instructor Budget Code(s): 29430320-630000 Vendor 4 61838 (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 [_� «- �x Date: 6/29/2015 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 i ur�pce tandards,specifications,and requirements: �ocuSigned""�y:''111L Office of the Risk Management Officer F uSa 66vvu 6 Date: 6/29/2015 7FDCF9176800498... Financial Services This instrument has been pre-audited in the 6n&q geer�yquired by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer b�' Date: 6/29/2015 232DFFC2CFA847B... Legal Services This agreement is approved as to 1 ofgjWm�sufficiency: Office of the County Attorney Date: 6/29/2015 4035CB8304CA4A9... 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