HomeMy WebLinkAboutR 2017-338-E Aging - Martha Broda for wellness instructor DocuSign Envelope ID:4F5BB1 FB-3D07-4404-943F-42364864E179
ORANGE COUNTY-DEPARTMENT USE ONLY
Department
Party/Vendor Name: Martha Broda Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 1388 Maims Chapel Road City Pittsboro State: NC Zip: 27312 Department: Aging Amount: $2,000
Purpose: Wellness Instructor Budget Code(s): 29430320-630000 Vendor#58627 (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 technirgal uSi fagned rm gy:nd content:
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�611AA t, �i1LL4 7/20/2017
Department Director's Signature` Date:
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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:
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Office of the Risk Management Officer aMtS& Cbvwc Date: 7/20/2017
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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 0.o Date: 7/20/2017
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Legal Services
This agreement is approved as to legobr1 ai�d sufficiency:
ocu igne y:
a ov oit, -Nto 7/24/2017
Office of the County Attorney Date:
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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