HomeMy WebLinkAboutR 2015-579-E Aging - Ruth Merrick for Senior Center instructor DocuSign Envelope ID: 38143D20-59F4-4FOF-B43E-EFE72B63OE83
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ORANGE COUNTY—DEPARTMENT USE ONLY
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Department
Party/Vendor Name: Ruth Merrick Parry/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 215 S. Hillsborough Ave City Hillsborough State: NC Zip: 27278 Department: Aging Amount: $3,000.00
Purpose: senior centers instructor Budget Code(s): 10430120-629000 Vendor#58822 (N/A if new vendor) Vendor
is a BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New ❑ Renewal ® Amendment ❑ Effective
Date September 15,2015 Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to technical form and content:
DocuSigned by:
Department Director's Signature Jiu- fi Date: 9/14/2015
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Information Technologies
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(Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is r
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approved as to information technology content and specifications:
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Office of the Chief Information Officer Date:
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Risk Management
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This agreement is approved for sufficiency of insurance standards,specifications,and requirements:
DocuSigned by:
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Office of the Risk Management Office aura vvt,e 6 Date. 9/15/2015
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Financial Services
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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 Officerx Date: 10/28/2015
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Legal Services
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This agreement is approved as to legal form and sufficiency:
DocuSigned by:
Office of the County Attorney po Date: 10/29/2015
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Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloda,oran eg countync. ov
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The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board Date:
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Revised 10/14 4