HomeMy WebLinkAboutR 2019-170 Aging - Tamara Freedman acupuncture DocuSign Envelope ID:7CD07906-463A-47D7-B030-F7EB5FA20DCB
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Tamara Freedman Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 174 Torain Street City Hillsborough State:NC Zip: 27278 Department: Aging Amount: $500.00 Purpose:
Acupuncture Budget Code(s): 29430320-630000 Vendor # N/A (N/A if new vendor) Vendor is a BOCC
consultant? Yes ❑ No❑ Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date March
11,2019 Approved by Board Yes❑Nor-1 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::
Department Director's Signatu �ctln.i�t, Date:3/11/2019
Agreements for emergency servic' B7E962❑1BF454FA.. abject 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 Office QU56 3/11/2019
�,4Wt.t,{�6 Date:
7FDCF917e800498.
Financial Services
This instrument has been pre-audited in the manner reauired by the Local Government Budget and Fiscal Control Act:
DocuSigned by:
Office of the Chief Financial Officerlr7NE5181ACC1409
3/13/2019
Date: _
.
Legal Services
This agreement is approved as to legal form and sufficiency:
C_
DocuSigned by:
Office of the County Attorn Date:
3/14/2019
4035CB8304CA4M
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