HomeMy WebLinkAboutR 2016-477-E Aging - Jennifer Sugg for Fit Feet nurse DocuSign Envelope ID:494289F0-8E30-4C81-8483-99B39200A68F
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Jennifer Sugg Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: PO Box 272 City Bynum State: NC Zip: 27228 Department: Aging Amount: $2,500 Purpose: Fit Feet
nurse Budget Code(s): 29430320-622000 Vendor#63091 (N/A if new vendor) Vendor is a BOCC consultant? Yes
❑ No❑ Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective Date August 10, 2016
Approved by Board Yes❑No® Agenda Date:
This agreement is approved as to technical form and content:
DocuSigned by:
Department Director's Signature � 1GL :�'r Date: 8/20/2016
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:
Fmso,DocuSigned_by:'ll g (hn tl6 8/22/2016
Office of the Risk Mana ement Officer Date:
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: 8/22/2016
7D4E5181ACC1409...
Legal Services
This agreement is approved as to lei 1 fi %nd sufficiency:
ocu igned T.
Office of the County Attorneys Date: 8/23/2016
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