HomeMy WebLinkAboutR 2017-199-E Aging - Arlene Bynum-Mills for wellness instructor DocuSign Envelope ID:D60198FD-0622-47EC-9846-C5E0B99AC13C
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Arlene Bynum-Mills Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 213 Rosaline Lane City Durham State: NC Zip: 27713 Department: Aging Amount: $400.00 Purpose:
Wellness Instructor Budget Code(s): 10430120-770105 Vendor#64460 (N/A if new vendor) Vendor is a BOCC
consultant? Yes ❑No Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 5/01/17
Approved by Board Yes No Agenda Date:
This agreement is approved as to technical form and content:
/^--DocuSigned by:
ou
^ iu, 'r�
Department Director's Signature J Date: 5/25/2017
s 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:
r----DocuSigned by:
""� ''��. 5/30/2017
Office of the Risk Management Officer ausa rtAA 116 Date:
``,. 7 FDC F9176800498...
Financial Services
This instrument has been pre-audited in the manneigned r requby: ired by the Local Government Budget and Fiscal Control Act:
ocu
Office of the Chief Financial Office 5/30/2017
�a 0°". a°'z Date:
7D4E5181 ACC1409...
Legal Services
This agreement is approved as to legalpforz g auplysufficiency:
Office of the County Attorney a '1' L to Date: 5/31/2017
\^—079A4D525COF4FB...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd @orangecountync.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 2/17 5