HomeMy WebLinkAboutR 2016-403-E Health - Barbara Lang for wellness instructor DocuSign Envelope ID: F91 F01 15-EFC8-4DD2-83F6-8AA6A5EFF7D8
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Barbara Lang Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 905 Cedar Fork Trail City Chapel Hill State:NC Zip: 27514 Department: Aging Amount: $5,000 Purpose:
Wellness Instructor Budget Code(s): 29430320-630000 Vendor#44068 (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:
h DocuSigned by:
J
Department Director's Signature Date: 7/22/2016���
67E962D18F454FA...
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:
DocuSigned by:
Office of the Risk Management Officer FllS. nt,t N Date: 7/25/2016
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 (' �°n.�l Date: 7/25/2016
7D4E5181ACC1409...
Legal Services
This agreement is approved as to legal form and sufficiency:
igned by:
Office of the County Attorney DocuS Date: 7/25/2016
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