HomeMy WebLinkAboutR 2019-364 Aging - Salli Benedict exercise instructor DocuSign Envelope ID:76912935-F100-406D-98F4-3A5B3D661849
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Salli Benedict Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 302 Waterside Dr City Carrboro State: NC Zip: 27510 Department: Aging Amount: $3,000 Purpose:
Wellness Instructor Budget Code(s): 29430320-630000 Vendor# 38196 (N/A if new vendor) Vendor is a BOCC
consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective Date
07/01/2019 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 Signature �G iu, �t�t,[.+'' Date: 6/21/2019
Agreements for emergency services NE962D,eF4s4FA.. ect 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:
F17FDCRP176WG498-.
uSigned by:Office of the Risk Management Officer & �,bVln t. b Date:6/22/2019
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 OfficerEr7D4F51&1ACC14N_.
•10-. Date: 6/24/2019
Legal Services Services
This agreement is approved as to legal form and sufficiency:
DocuSigned by
Office of the County Attorney ��� � Date:
6/24/2019
4o35CB8304CA4A9
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