HomeMy WebLinkAboutR 2019-449 Aging - Kevin Kirk wellness instructor DocuSign Envelope ID: B45C9250-22E8-4A69-833D-4EE928A9770D
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: Kevin Kirk Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 5311 Beaumont Dr City Durham State:NC Zip: 27707 Department: Aging Amount: $15,000 Purpose:
Wellness Instructor Budget Code(s): 29430320-630000 Vendor # 34783 (N/A if new vendor) Vendor is a
BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective
Date 07/01/2019 Approved by Board Yes❑Nor-1 Agenda Date:
This agreement is approved as to technical form and content and I as Department Director affirmatively state work
on this project has not been initiated prior to execution of the agreement:
h D�o"Signed by:
J t ��� 6/30/2019
Department Director's Signature_ B7E962❑1BF454FA.. Date:
Agreements for emergency services or repair are not subject to the above affirmation. If services related to this
agreement have already begun or been completed please briefly describe the nature of the emergency condition that
was addressed:
Information Technologies
(Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is
approved as to information technology content and specifications:
Office of the Chief Information Officer Date:
Risk Management
This agreement is approved for sufficiency r Docusignea by: is,specifications,and requirements:
t$a QC
Office of the Risk Management Officer �,4Wt.t,�6 Date: 6/30/2019
7FDCF0176800408.
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 A Date: 6/30/2019
- 704E51S1ACC1409.
Legal Services
This agreement is approved as to legal D-uSigned by:
7/1/2019
Office of the County Attorney 4035CB8304CA4M Date:
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
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