HomeMy WebLinkAboutR 2019-369 Aging - Lorraine Lewis wellness instructor DocuSign Envelope ID:088E9D73-6D60-4316-99EB-19302C74139C
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Lorraine Lewis Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 107 Morningside Dr City Carrboro State: NC Zip: 27510 Department: Aging Amount: $2,000 Purpose:
Wellness Instructor Budget Code(s): 29430320-630000 Vendor# 57608 (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: 6/21/2019
Department Director's Signature 1Glln.iu, �b_r Date:
Agreements for emergency services B7E962D1BF454FA.. 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 QU50. (h4 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 Cc Date: 6/24/2019
7NE5181ACC1409.
Legal Services
This agreement is approved as to leeal form and sufficiency:
DocuSigned by:
6/24/2019
Office of the County Attorney Date.
4035CB8304CA4Ae
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