HomeMy WebLinkAboutR 2019-144 Aging - Pamela Epperson pottery instruction DocuSign Envelope ID: F090CE37-4633-44DB-A8FB-8A67D31CC1C3
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Pamela Epperson Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 4611 Powder Mill Rd City Chapel Hill State: NC Zip: 27514 Department: Aging Amount: $1,300
Purpose: class instructor Budget Code(s): 10430120-629000 Vendor # 64469 (N/A if new vendor) Vendor is a
BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date
3/01/19 Approved by Board Yes❑No❑ Agenda Date:
This agreement is approved as to technical form and content and I as Department Director affirmatively state work on
this project has not been initiated prior to execution of the agreement:
Docusigned by::- '_ 3/1/2 019
Department Director's Signature �aan.iGt, �+�b_r Date:
Agreements for emergency services of NE962D16F454FA.. A to the above affirmation. If services related to this
agreement have already begun or been completed please briefly describe the nature of the emergency condition that was
addressed:
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:
DocuSigned by,
Office of the Risk Management Officer aUSA c4_ 6 Date:3/5/2019
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 t r 4 3/6/2019 Date: _
7n4E51S1ACC1409.
Legal Services
This agreement is approved as to legal form and sufficiency:
Docusigned by: 3/6/2019
Office of the County Attorney ,w� Date:
4035C68304CA4M
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:
Revised 12/18 4