HomeMy WebLinkAboutR 2016-333-E Aging - Janice Galloway for Fit Feet nurse DocuSign Envelope ID:E9EF5F09-83C7-48AB-B736-FC3D8CO2309A
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Janice Galloway Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 6615 Glen Forest Dr City Chapel Hill State: NC Zip: 27517 Department: Aging Amount: $6,000 Purpose:
Fit Feet nurse Budget Code(s): 29430320-622000 Vendor # 58613 (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 technical form and content:
DocuSigned by:
Department Director's Signature
Date:6/27/2016
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:
DocuSigned_by:'
Office of the Risk Management Officer F&O, r,6nUff6 Date: 6/28/2016
7FDCF9176800498...
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 Date: 7/3/2016
7D4E5181ACC1409...
Legal Services
This agreement is approved as to legal form and sufficiency:
DocuSigned by:
Office of the County Attorney Da.te:7/6/2016
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