HomeMy WebLinkAboutR 2017-287-E Aging - Functional Fitness LLC for wellness instructor DocuSign Envelope ID:C9E84AFC-1 B8F-4774-8ACB-F00B2751 F1 F2
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Functional Fitness LLC Party/Vendor Contact Person: Kevin Kirk Contact Phone:
Party/Vendor Address: 5311 Beaumont Dr City Durham State: NC Zip: 27707 Department: Aging Amount: $12,000
Purpose: Wellness Instructor Budget Code(s): 29430320-630000 Vendor#34783 (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:
7/11/2017
Department Director's Signature j LUtA L- I t1 t ' Date:
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 MS& Cbb Date: 7/11/2017
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
, ---DocuSigned by:
7/11/2017
Office of the Chief Financial Officer rl � Date:-7D4E5181 ACC1409...
Legal Services
This agreement is approved as to legal form and sufficiency:
p--DocuSigned by:
y n U.�A. 1ST 7/11/2017
Office of the County Attorney Date:
`—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