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DocuSign Envelope ID:4DC98AE0-D25F-4801-877E-102F34C06A65 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Deuartment <br /> Party/Vendor Name: Linda Textoris,R.N. Party/Vendor Contact Person: Contact Phone: Party/Vendor <br /> Address: 750 Weaver Dairy Road, 4204 City Chapel Hill State: NC Zip: 27517 Department: Aging Amount: <br /> $7,000.00 Purpose: wellness instructor Budget Code(s): 29430320-622000 Vendor 4 58380 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ <br /> Effective Date July 1,2015 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to tecIpicalfarAlovd content: DocuSigned by: <br /> �AIn,tGt. fit��d V �aln,lGt, fi <br /> Department Director's Signature Date: y <br /> B7E962D1BF454FA... B7E962D1BF454FA... <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> DocuSigned by: DocuSigned by: <br /> Office of the Risk Management Officer PUS#, (,6V17t 6 Date:l7FDCF9176800498...usa, (,6m,&b <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in th �gdrWuired by the Local Government Bud et M4,Fiscal Control Act: <br /> ����(�� ocu igned <br /> Office of the Chief Financial Officer P� �,"-"'D 6VU Date PMAL VU <br /> 232DFFC2CFA847B... 232DFFC2CFA847B... <br /> Legal Services <br /> This agreement is approved as C4035CB8304CA4Ag..al Born,and sufficiency: <br /> ocu igne y: <br /> d 6/23/2015 <br /> Office of the County Attorne 4jj, I Date: <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ DolloyLyorangecou go v <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> Office of the Clerk to the Board Date: <br /> Revised 10/14 4 <br />