HomeMy WebLinkAboutR 2016-378-E Aging - Functional Fitness, LLC for wellness instructor DocuSign Envelope ID:6647E338-085A-4D3E-B45C-6D9ECB0533C1
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Functional Fitness, LLC Party/Vendor Contact Person: Kevin Kirk Contact Phone:
Party/Vendor Address: 5311 Beaumont Dr City Durham State:NC Zip: 27707 Department: Aging Amount: $12,000
Purpose: Wellness Instructor Budget Code(s): 29430320-630000 Vendor#34783 (N/A if new vendor) Vendor is a
BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New❑ Renewal® Amendment ❑ Effective Date
July 21,2016 Approved by Board Yes❑No® Agenda Date:
This agreement is approved as to technil f�aigmnd content:
CE& fi(�r Department Director's Signature Date: 7/19/2016
62D18F454FA...
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:
Docugned by: 1111 Office of the Risk Management Officer FauSi
s . ('6'n' & Date: 7/19/2016
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in the,om rmngbyequired by the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer E7D4E5181ACC1409�_ Date: 7/20/2016
.
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney s 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