R 2015-280-E Aging - Sarah Benedict for wellness instructor

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DocuSign Envelope ID: 5C4F3E91-6CBB-4EE5-8507-23A674D21410 ORANGE COUNTY-DEPARTMENT USE ONLY Department Party/Vendor Name: Sarah Benedict Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: 302 Waterside Drive City Carrboro State:NC Zip:27510 Department: Aging Amount: $4,000.00 Purpose: wellness instructor Budget Code(s): 29430320-630000 Vendor 4 38196 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New ❑ Renewal ❑ Amendment ❑ Effective Date July 1, 2015 Approved by Board Yes❑No❑ Agenda Date: This agreement is approved as to technical form and content: DocuSigned by: Department Director's Signature [_,� U_ - �x Date: 6/22/2015 B7E962D1BF454FA... 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 insurance standards,specifications,and requirements: DocuSigned""by: ''111L Office of the Risk Management Officer allStU (hVV,&b Date:6/23/2015 7FDCF9176800498... Financial Services This instrument has been pre-audited in .BM „�6d-gffuired by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer PMAL ['"-+6VU Date: 6/23/2015 232DFFC2CFA847B... Legal Services This agreement is approved as to legal for gmeaanbd sufficiency: Office of the County Attorney , 1 Date: 6/23/2015 4035CB83046A4A9... 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