HomeMy WebLinkAboutR 2017-260-E Aging - Michelle Rogers, Inc. for wellness instructor DocuSign Envelope ID:3ECD34E0-30A5-406A-BBDE-EAF874C81FCD
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Michelle Rogers, Inc. Party/Vendor Contact Person: Contact Phone:
Party/Vendor Address: 210 Virginia Lee Lane City Efland State: NC Zip: 27243 Department: Aging Amount:
$2,400 Purpose: Wellness Instructor Budget Code(s): 10430120-770105 Vendor # 64462 (N/A if new vendor)
Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ❑ Renewal ® Amendment ❑
Effective Date 7/01/17 Approved by Board Yes' No Agenda Date:
This agreement is approved as to technical form and content:
/^--DocuSigned by:
Department Director's Signature �a�,tu. �i �t V Date: 6/30/2017
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:
Office of the Risk Management Officer MSA '_ 'ull 16 7/3/2017
rbvvt 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 l'l Date:7/3/2017
7D4E5181ACC1409...
Legal Services
This agreement is approved as to legal form and sufficiency:
p--DocuSigned by:
Office of the County Attorney abUAL L 1 sco Date: 7/3/2017
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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