HomeMy WebLinkAboutR 2017-325-E Aging - Shu Hwa Fan for wellness instructor DocuSign Envelope ID:80CDDOE6-7F74-4289-9C39-8D8E11AOD8B6
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Shu Hwa Fan Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 120 Virginia Drive City Chapel Hill State: NC Zip: 27514 Department: Aging Amount: $1,200 Purpose:
Wellness Instructor Budget Code(s): 10430120-770105 Vendor#64655 (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 technicalDfghvgdycontent:
Department Director's Signature Jai�u' � Date: 7/17/2017
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 aMMS& 661(Vu'll Date: 7/17/2017
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
, ---DocuSigned by:
7/17/2017
Office of the Chief Financial Officer rI Date:-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: 7/17/2017
`—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