HomeMy WebLinkAboutR 2019-633 Aging - William Meyers wellness instructor aoi 9 � � 33
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name : William Meyers Party/Vendor Contact Person : Contact Phone : Party/Vendor
Address : 1204 Little Creek Rd City Durham State : NC Zip : 27713 Department $ Aging Amount : $ 2 , 000 Purpose :
Wellness Instructor Budget Code (s) : 29430320 - 630000 Vendor # 56366 (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 .
Department Director ' s Signature Date $
Agreements for emergency services o ep rr are not subject t e above affirmation . If services related to this
agreement have already begun or be mpleted please briefly describe the nature of the emergency condition that was
addressed :
Information Technolol4ies
(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 :
Office of the Risk Management Officer ) Date :
WingCifigilvices
This instrument has been pre- audited in the manhe Local Government Budget and F ' scal Control Act :
r / f
Office of the Chief Financial Officer Date :
Lel4aI Services
This agreement is approved as to legal f and sufficiency :
Office of the County Attorney Date : 1, j � 1
Clerk to the Board
Received for record retention :
All Docusign contracts must be copied to Sherri Ingersoll upon completion : smgersoll@orangecountync . gov
The following signature block is for hard copies only and is not required for Docusign contracts :
Office of the Cleric to the Board Date ;
Revised 12/ 18 4