HomeMy WebLinkAboutR 2016-332-E Aging - Janet Whitesides for Fit Feet nurse DocuSign Envelope ID:8E16CE34-27OB-4B2D-AC61-A73lB2DODF61
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Janet Whitesides Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 107 Center Street City Carrboro State: NC Zip: 27510 Department: Aging Amount: $4,000 Purpose: Fit
Feet nurse Budget Code(s): 29430320-622000 Vendor ff 62174 (N/A if new vendor) Vendor is a BOCC consultant?
Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective Date July 1, 2016
Approved by Board Yes❑No® Agenda Date:
This agreement is approved as to techni6gkk Q Wd content:
Department Director's Signature '«t' Date: 6/28/2016
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 insurance standards,specifications,and requirements:
Fmso,DocuSigned_by:'ll g (hnutl6 6/29/2016
Office of the Risk Mana ement Officer Date:
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
DocuSigned b :
Office of the Chief Financial Officer ����� Date:
7/5/2016
7D4E5181ACC1409...
Legal Services
This agreement is approved as to legal form and sufficiency:
DocuSigned by:
Office of the County Attorney Date: 2/6/2016
4035CB8304CA4A9...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydgoran eg countync•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 6/16 5