HomeMy WebLinkAboutR 2019-586 Aging - Russell Knopp wellness instructor DocuSign Envelope ID: E2F57DC2-1B6D-4E6E-8305-D7B1E8BE9124
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Russell Knopp Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 1021 Alexander Steward Dr City Hillsborough State: NC Zip: 27278 Department: Aging Amount:
7 800 Purpose: Senior Center Instructor Budget Code(s): 10430120-629000 Vendor # 44521 (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❑No❑ 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 51AaMU_ b-r Date: 8/27/2019
Agreements for emergency services Owikawa,qjWubject 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"" b by:''11
Office of the Risk Management OfficerPUSA, rbrvu Date:8/27/2019
7FDCF9176800498...
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act:
cuSigned by: 8/27/2019
Office of the Chief Financial Officer Do s�P,ia�a�sc Date:
7D4E5181ACC1409...
Legal Services
This agreement is approved as to legal form and sufficiency:
DocuSigned by:
Office of the County Attorney Date: 8/27/2019
4035CB8304CA4A9...
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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