HomeMy WebLinkAboutR 2017-291-E Aging - Kathleen Hammon for wellness instructor DocuSign Envelope ID:D49A8E11-5233-458F-865E-DEB58D7F1091
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Kathleen Hammon Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 1102 E Franklin St City Chaoel Hill State: NC Zip: 27514 Department: Aging Amount: $3,000 Purpose:
Wellness Instructor Budget Code(s): 10430120-770105 Vendor#56311 (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:
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/- ocuSigned y:
7/12/2017
Department Director's Signature J10-- 1-11(1-r 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 aMtS& rbi l&th Date: 7/13/2017
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
, ---DocuSigned by:
Office of the Chief Financial Officer Date:
7/13/2017
—7D4E5181 ACC1409...
Legal Services
This agreement is approved as to legal form and sufficiency:
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Office of the County Attorney
0.t,u, L hark, 1 Scb Date: 7/13/2017
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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