HomeMy WebLinkAboutR 2017-286-E Aging - Janice Galloway for wellness instructor DocuSign Envelope ID:AEC896C7-7694-4887-A4FE-8A80ADE254E5
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Janice Galloway Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 6615 Glen Forest Dr City Chapel Hill State: NC Zip: 27517 Department: Aging Amount: $6,000 Purpose:
Wellness Instructor Budget Code(s): 29430320-622000 Vendor#58613 (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 ja kAa- � t V Date:
7/10/2017
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:
aLtS& Cb b 7/11/2017
Office of the Risk Management 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
Office of the Chief Financial Officer /11/2017
�a� °". a°'z Date:ate:
-7D4E5181 ACC1409...
Legal Services
This agreement is approved as to legal form and sufficiency:
p--DocuSigned by:
Office of the County Attorney ate, hark, 1 sco Date: 7/11/2017
`—079A4D525C0F4FB...
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