HomeMy WebLinkAboutR 2015-603-E Aging - Janet Whiteside, RN for wellness instructor DocuSign Envelope ID:442C35DB-8F7E-464D-90B8-19DA4AF12B4F
ORANGE COUNTY-DEPARTMENT USE ONLY
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Department
Party/Vendor Name: Janet Whitesides R.N. Party/Vendor Contact Person: Contact Phone:
Party/Vendor Address: 107 Center St City Carrboro State: NC Zip: 27510 Department: Aging Amount: $5,000.00
Purpose: wellness instructor Budget Code(s): 29430320-622000 Vendor#62174 (N/A if new vendor) Vendor is a
BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New❑ Renewal ® Amendment ❑ Effective Date
November 21,2015 Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to technical form and content:
DocuSigned by:
Department Director's Signature 11f 1- fi Date: 11/19/2015
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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:
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Office of the Chief Information Officer Date:
Risk Management
This agreement is approved for sufficiency of insurance standards,specifications,and requirements:
P DocuSigned"by:'USA. r,6vvt,e 6 11/19/2015
Office of the Risk Management Officer Date:
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Financial Services f
This instrument has been pre-audited in the WaTe Nr Aired by the Local Government Budget and Fiscal Control Act:
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Office of the Chief Financial Officer
( '�°' '� Date: 11/20/2015
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Leizal Services
This agreement is approved as to legal forrm and sufficiency:
11/20/2015
Office of the County Attorney Date:
4035CB8304CA4A9...
Cleric to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecoupVnc.gov
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
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