R 2014-567 Aging - Frank Pruett for T'ai Chi Class $2,000

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DocuSign Envelope ID: F67B2749-18A3-4DB7-997D-717F325A6955 ORANGE COUNTYDEPARTMENT USE ONLY NOT A CONTRACT EXHIBIT OR ATTACHMENT ______________________________________________________________________________ Department Party/Vendor Name: Frank Pruett Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: 2648 Burton Rd City Durham State: NC Zip: 27704 Department: Aging Amount: $2,000.00 Purpose: T'ai Chi Class Budget Code(s): 29430320-630000 Vendor # 62642 (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal Amendment Effective Date 10/01/14 Approved by Board Yes No Agenda Date: This agreement is approved as to technical form and content: ________________________________________ Date: ________ 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 Director of Information Technology ___________________________ Date: ________ Risk Management This agreement is approved for sufficiency of insurance standards, specifications, and requirements: Office of Risk Management _____________________________________________ Date: _________ Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer ____________________________________ Date: _________ Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney __________________________________________Date: ________ Clerk to the Board Received for record retention: Office of the Clerk to the Board __________________________________________Date:_________ 4 Revised 7/14