HomeMy WebLinkAboutR 2016-377-E Aging - Return 2 Recess for wellness instructor DocuSign Envelope ID:61058E40-1A9C-468F-A21D-D525A55FD8DB
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Return 2 Recess Party/Vendor Contact Person: Kim Saffran Contact Phone: 919-599-4696
Party/Vendor Address: P O Box 106 City Carrboro State: NC Zip: 27510 Department: Aging Amount: $1,500
Purpose: Wellness Instructor Budget Code(s): 29430320-630000 Vendor# (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 technic4 fQ n .content:
DDepartment i 4FA Director's Signature Date: 7/19/2016
Information Technolosies
(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:
Docu5igned""by:
''11i1
Office of the Risk Management Officer Pausa, (,6rvu,�16 Date: 7/19/2016
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in th � jd�,�quired by the Local Government Budget and Fiscal Control Act:
7/20/2016
Office of the Chief Financial Officer r `�°'�" �°'v Date:
7D4E5181ACC1409...
Legal Services
This agreement is approved as to legal form and sufficiency:
ocuSigned by:
Office of the County Attorney E��EK Date: 7/20/2016
4035CE8304CA4A9...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloy(d c�orangecount.nic.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