HomeMy WebLinkAboutR 2016-435 Aging - Seine Wolfe for wellness instructor ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Seine Wolfe Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 909 Palmers Grove Church Rd City Hillsborough State: NC Zip- 27278 Department: Aug Amount:
$2,000 Purpose: Wellness Instructor Budget Code(s): 10430120-770105t/Vendor # 58051 (N/A if new vendor)— k�
Vendor is a BOCC consultant? Yes ❑ Nor-1 Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ v�r �
Effective Date August 15,2016 Approved by Board Yes[]No® Agenda Date:
This agreement is approved as to technical form and content:
Department Director's Signature Date: Jk-/040
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 b
Fin cial Wrvices
This instrument has been pre-audited in the marine r qu' b the cal Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer Date: g/S
V/I t-, - F -
Legal Services
This agreement is approved as to legal fo suf c y:
Office of the County Attorney Date: `I
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecountvnc.gov
The following signature block is for hard copies y s n required for Docusign contracts:
Office of the Clerk to the Board Date:`[(,
Revised 6/16 5