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DocuSign Envelope ID: EACBD833-2A78-4046-B904-6CCD2F4B10BD <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Steven Dr s� Party/Vendor Contact Person: Contact Phone: Party/Vendor <br /> Address: 5007 Mill Hill Lane City Chapel Hill State: NC Zip: 27517 Department: wing Amount: $990.00 <br /> Purpose: Wellness Instructor Budget Code(s): 29430320-630000 Vendor 4 62949 (N/A if new vendor) Vendor is a <br /> BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New ❑ Renewal ® Amendment ❑ Effective Date <br /> July 1,2015 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> DocuSigned by: <br /> P « fi�X Date: 6/22/2015 <br /> Department Director's Signature y <br /> 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 iRsur�anc�standards,specifications,and requirements: <br /> ocu 1gneY' by:''111L <br /> Office of the Risk Management Officer F uSa �,bvvu 6 Date: 6/23/2015 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Officer bvu Date: <br /> 6/23/2015 <br /> 232DFFC2CFA847B... <br /> Legal Services <br /> This agreement is approved as to C.�,m sufficiency: <br /> Office of the County Attorney 1� Date: 6/23/2015 <br /> 035CB8304CA4A9... <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 />