HomeMy WebLinkAboutR 2016-383 Aging - Nancy Dede Banks for wellness instructor ORANGE COUNTY—DEPARTMENT USE ONLY r) 383
Department
Party/Vendor Name: Nancy Dede Banks Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 747 Rock Rest Rd City Pittsboro State: NC Zip: 27312 Department: Aging Amount: 000 Purpose:
Wellness Instructor Budget Code(s) 9430320-630000 Vendor#55776 (N/A if new vendor) Vendor is a BOCC
consultant? Yes ❑No❑ Contract Type:(Check one)New❑ Renewal® Amendment ❑ Effective Date July 31,
2016 Approved by Board Yes❑No® Agenda Date:
This agreement is approved as to technical form and content:
Department Director's Signature Date:
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:
Office of the Risk Management Officer l (/ Date: — J°
Financial Services
This instrument has been pre-audited in the er u ed the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer . Date: 2S
Legal Services
This agreement is approved as to legal f and sufficiency:
Office of the County Attorney Dater (o
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@oran eg coun nc.gov
The following signature block is for hard copies d' not r quired for Docusign contracts:
Office of the Clerk to the Board Date:
Revised 6/16 5