HomeMy WebLinkAboutR 2016-482-E Aging - Kathleen Hammon - wellness instructor DocuSign Envelope ID:270479C5-FCF2-4407-B265-35CF6C5408CF
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Kathleen Hammon Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 1102 E Franklin St City Chapel Hill State: NC Zip: 27514 Department: Aging Amount: $4,000 Purpose:
Wellness Instructor Budget Code(s): 10430120-770105 Vendor#56311 (N/A if new vendor) Vendor is a BOCC
consultant? Yes ❑ No❑ Contract Type: (Check one)New ❑ Renewal ® Amendment ❑ Effective Date July 28,
2016 Approved by Board Yes❑No® Agenda Date:
This agreement is approved as to technicgo fgrm yd. content:
5 Department ,u, -�l y Director's Signature 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:
F&O,DocuSignedby:Office of the Risk Management Officer rbvvutl6 Date: 8/22/2016
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
ocuSigned b
Office of the Chief Financial Officer F��N Date: 8/22/2016
7D4E5181ACC1409...
Legal Services
This agreement is approved as to le, l fo n� id sufficiency:
ocu vgne y:
8/Z3/2016
Office of the County Attorney � Date:
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