HomeMy WebLinkAboutR 2020-186 Aging - Valerie Roberts wellness instructor DocuSign Envelope ID: B62ADD07-054A-4EAE-9F8A-lC671D8F3743
ORANGE COUNTY-DEPARTMENT USE ONLY
Party/Vendor Name: Valerie Roberts Party/Vendor Contact Person: Contact Phone: Party/Vendor
Address: 1501 Kirkwood Drive City Durham State: NC Zip: 27705 Department: Aging Amount: 1000 Purpose:
Senior Center Instructor Budget Code(s): 10430120-629000 Vendor # 61484 (N/A if new vendor) Vendor is a
BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New® Renewal ❑ Amendment ❑ Effective Date
03/10/2020 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:
D
DocuSigned by:
t '�� 3/5/2020
Department Director's Signature 67 Date:
E962D16F454FA...
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 a66 L.Qw 6_ Date:3/6/2020
7FDCF9176800408...
Financial Services
This instrument has been pre-audited in ' Docusigned by: ' '' he Local Government Budget and Fiscal Control Act:
1r1)'N4 � 3/10/2020
Office of the Chief Financial Officer Date:- 704E5181ACC1409...
Legal Services
This agreement is approved as to DocuSigned by: icy:
Office of the County Attorney ' ' - Date: 3/10/2020
4035C68304CA4M...
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