HomeMy WebLinkAboutR 2019-393 Aging - Bruce Gillooly wellness instructor DocuSign Envelope ID:A98DCD1 C-1 BD8-44F7-9091-4D8C9CB377C4
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Bruce Gillooly Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 346 Chatham Dr City Chapel Hill State: NC Zip: 27516 Department: Aging Amount: $2,000 Purpose:
Senior Center Instructor Budget Code(s): 10430120-629000 Vendor # 51330 (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:
h DocuSigned by::
Department Director's Signature a tu, �+�b_r Date: 6/30/2019
Agreements for emergency services c NE962D1BF454FA.. ;ct 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
QU56 (hQ 6 Date: 7/1/2019
7FDCF9176900498.
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
DocuSigned by:
Office of the Chief Financial Officer t r 4 Date: 7/1/2019
704E51S1ACC1469.
Legal Services
This agreement is approved as to legal form and sufficiency:
DocuSigned by:
7/1/2019
Office of the County Attorney � � a Date:
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