HomeMy WebLinkAboutR 2020-152 Aging - Louise Keefer wellness instructor DocuSign Envelope ID:ACBA2531-E059-4651-9BC6-691B99462895
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: Louise Keefer Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 909 B ShadyLawn Road Ext City Chapel Hill State: NC Zip: 27514 Department: Aging Amount: $1,000
Purpose: Wellness Instructor Budget Code(s): 10430120-770105 Vendor#66023 (N/A if new vendor) Vendor is a
BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date
03/01/2020 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:
DNE962MBF454FA...
DocuSigned by:
'�� 2/26/2020
Department Director's Signature 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 sufficienc oocu's;9nea by:-1--ds, specifications,and requirements:
Office of the Risk Management Officer �66 (,4Wt.t 6_ Date: 2/27/2020
7FDCF8176800408...
Financial Services
This instrument has been pre-audited i Docusigned by: the Local Government Budget and Fiscal Control Act:
('q�,s� 2/27/2020
Office of the Chief Financial Officer 7DaE5ls,acc,4as... Date:
Legal Services
This agreement is approved as to D"ocusigned by: - icy:
2/27/2020
Office of the County Attorney. 4035C68304C'A4Ae...`- 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 4