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HomeMy WebLinkAboutR 2019-629 Aging - Charron Andrews wellness instructor DocuSign Envelope ID:74F011EB-23A7-4767-91C1-8E4C25122630 ORANGE COUNTY—DEPARTMENT USE ONLY Party/Vendor Name: Charron Andrews Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: 108 Cottonwood Ct City Chapel Hill State:NC Zip: 27514 Department: Aging Amount: $2,500 Purpose: Wellness Instructor Budget Code(s): 29430320-630000 Vendor# 38424 (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 � i -' Date: 9/9/2019 Agreements for emergency services NE962❑1BF454 FA.. jest 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 aUS& C,bV1rt.Ch Date:9/9/2019 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: 9/9/2019 7NE5181ACC1409. Legal Services This agreement is approved as to legal form and sufficiency: Docusigned by: Office of the County Attorney �,,O fay Date: 9/13/2019 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