HomeMy WebLinkAboutR 2019-368 Aging - Stephanie Yost wellness instructor DocuSign Envelope ID: B638A201-1034-4E14-85DE-7ECA20CC1687
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Stephanie Yost Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 7700 Amesbury Dr City Chapel Hill State:NC Zip: 27514 Department: Aging Amount: $4,800 Purpose:
Wellness Instructor Budget Code(s): 29430320-630000 Vendor# 34784 (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:
CU
DocuSigned by:
Department Director's Signature �tu, -lbw Date: 6/22/2019
Agreements for emergency services UE962❑1BF454FA.. 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:
DocuSigned by:
Office of the Risk Management Officer us a, (��6 Date: 6/22/2019
7FDCF9176800498.
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 Officer Cr Date: 6/24/2019
7NE5181 ACC 1409.
Legal Services
This agreement is approved as to legal form and sufficiency:
DocuSigned by:
Office of the County Attorne �� �, Date:
6/24/2019
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