HomeMy WebLinkAboutR 2019-148 Aging - Dan Eubanks instructor ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name : Dan Eubanks Party/Vendor Contact Person : Contact Phone : Party/Vendor
Address : 2300 Judah Benjamin Ct . City l4illsborough State : NC Zip : 27278 Department : Aging Amount : $ 2 , 000
Purpose : class instructor Budget Code ( s*60430120mw629000 Vendor 62349 (N/A if new vendor) Vendor is a
BOCC consultant? Yes ❑ No ❑ Contre : ( Check one ) New Renewal ® Amendment ❑ Effective Date
3 /01 / 19 Approved by Board Yes ❑ Nogenda 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 :
Department Director ' s Signature Z2 Date : Y AL /7
Agreements for emergency services r re it are not subject to th above affirmation . If services related to this
agreement have already begun or be completed please briefly describe the nature of the emergency condition that was
addressed :
Information Technologies
(Applicable only to hardN) are/sofhvare 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_ 0000t�- � t�..�^- -�� Date : 31 7 cl
Finanicial ,Services
This instrument has been pre - audited in the m er r it by the Local Government Budget and Fiscal Control Act :
Office of the Chief Financial Officer Date : 517Z51119
Legal Services
This agreement is approved as to legal f rm nd sufficiency :
Office of the County Attorney Date : 3 � �
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