R 2015-188-E DEAPR - Nina Maier for tai chi instruction

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DocuSign Envelope ID: 1845BDA8-DB24-47EO-AOC4-C533E5FD966B ORANGE COUNTY—DEPARTMENT USE ONLY Deuartment Party/Vendor Name: Party/Vendor Contact Person: Nina Maier Contact Phone: (919)732-2722 Party/Vendor Address: 3302 Pearson Road City Hurdle Mills State: NC Zip: 27541 Department: DEAPR Amount: $359.00 Purpose: Tai Chi Instruction Budget Code(s): 10511020 630000 Vendor 4 51178 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date April 15,2015 Approved by Board Yes❑No❑ Agenda Date: VDoWySi ned bThis agreement is approved as to technical o c fentaSfav�U� 4/20/2015 Department Director's Signature 611CFA1D507A495... 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 Chief Information Officer Date: Risk Management This agreement is approved for sufficiency of i Mcl ijWAgards,specifications,and requirements: Qusa, 66vvt,e 6 Office of the Risk Management Officer Date: 04/21/2015 F Financial Services This instrument has been pre-audited in t 4agnhpuired by the Local Government Budget and Fiscal Control Act: �AU� �bliL 4/21/2015 Office of the Chief Financial Officer o�F�eF�ae7 Date: Legal Services This agreement is approved as to leg 11' tinfficiency: ,�66U otxfs 4/21/2015 Office of the County Attorney Date: E-a43633Ee8A84o5... Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloyLyorangecou go v 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 10/14 4 ff