R 2015-284-E Aging - Joy Gornto for wellness instructor

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DocuSign Envelope ID:Al003872-9D23-4FA7-8905-86F251 B038BO ORANGE COUNTY-DEPARTMENT USE ONLY Deuartment Party/Vendor Name: Joy Gornto Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: 3431 Pickett Road City Durham State: NC Zip: 27705 Department: Aging Amount: $7,000.00 Purpose: wellness instructor Budget Code(s):29430320-630000 Vendor 4 61228 (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 technic 1 f rm nd content: �ocu�igned by: Department Director's Signature « Date: 6/24/2015 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: pDocuSigned""by:''111L Office of the Risk Management Officer US. (hnutt0 Date: 6/24/2015 7FDCF9176800498... Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: I—NAL DocuSigned by: 1 _ �b� 6/25/2015 Office of the Chief Financial Officer l�"� D ate: 232DFFC2CFA847B... Legal Services This agreement is approved as to r7.0-35—C ofgyxme sufficiency: Office of the County Attorney 1� Date: 6/25/2015 B8304C A4A9... 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