HomeMy WebLinkAboutR 2015-329-E Aging - Martha Broda for wellness instructor DocuSign Envelope ID:66806383-C635-48A3-B408-7BC6C50D832B
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Martha Broda Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 1388 Manus Chapel Road City Pittsboro State: NC Zip: 27312 Department: Aging Amount: $2,000.00
Purpose: wellness instructor Budget Code(s): 29430320-630000 Vendor 4 58627 (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 technicaj fob aid content:
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Department Director's Signature � Date: 7/8/2015
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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: 7/9/2015
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Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
DocuSigned by:
Office of the Chief Financial Officer P ( Date: 7/9/2015
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Legal Services
This agreement is approved as to legal form and sufficiency:
DocuSigned by:
Office of the County Attorney � , Date: 7/9/2015
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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