HomeMy WebLinkAboutR 2018-329 Aging - Jessica Mazyck wellness classesRevised 10/17 (Mgr apprv 5k 6/18)
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ORANGE COUNTY—DEPARTMENT USE ONLY
______________________________________________________________________________
Department
Party/Vendor Name: Jessica Mazyck Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 808 Southshore Pkwy City Durham State: NC Zip: 27703 Department: Aging Amount: $1,000 Purpose:
wellness classes Budget Code(s): 29430320-630000 Vendor # 65155 (N/A if new vendor) Vendor is a BOCC
consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date 7/01/18
Approved by Board Yes No Agenda Date:
This agreement is approved as to technical form and content:
Department Director’s Signature ________________________________________ Date: ________
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:
Office of the Risk Management Officer___________________________________ Date: _________
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
Office of the Chief Financial Officer ____________________________________ Date: _________
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney __________________________________________Date: ________
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@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:_________
DocuSign Envelope ID: 83D63124-715A-4F52-8DE3-E834335BBC52