HomeMy WebLinkAboutR 2019-428 Aging - Karah Alexis fit feet nursing services DocuSign Envelope ID:AD88A30A-1380-4BC7-91A7-9C3AB6E579EB
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: Karah Alexis Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 70 Southern Green Way City Chapel Hill State: NC Zip: 27517 Department: Aging Amount: $3,000
Purpose: Wellness Instructor Budget Code(s): 29430320-622000 Vendor#63090 (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 �ct n.iu, �t�tR.+'' Date:7/10/2019
Agreements for emergency services NE962❑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 Qusa. (,4�6 Date:7/10/2019
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 Cr7NE5181ACC1409
Date: 7/10/2019
.
Legal Services
This agreement is approved as to legal form and sufficiency:
DocuSigned by:
Office of the County Attorneys s.t� _ Date:
7/11/2019
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