R 2015-286-E Aging - Jennifer Sugg, RN for wellness instructor

Browse Search

DocuSign Envelope ID:84D563A0-30F8-4571-947C-73CC853AB58C ORANGE COUNTY-DEPARTMENT USE ONLY Department Party/Vendor Name: Jennifer Sum, R.N. Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: P O Box 272 City Bynum State: NC Zip: 27228 Department:Aging Amount: $5.000.00 Purpose:wellness instructor Budget Code(s): 29430320-622000 Vendor 4 63091 (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: WcuSigned by: Department Director's Signature s Tt by Date: 6/24/2015 UE902D1BF454FA... Information Technolouies (Applicable only to ha7rdwa7re/sofhva7re 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 irnurnnce,tandards, specifications, and requirements: Wousigned by: Office of the Risk Management Officer U501 (h1 6 Date: 6/24/2015 7FDCF9176800408... Financial Services This instrument has been pre-audited in*n°oaciasi�ned bx: ;—A 1the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer 6vu Date: 6/24/2015 2326FFC2CFA847B... Leual Services This agreement is approved as to le--' g PP OocuSigned by: Office of the County Attorney ?�'^ '•�"h- Date: 6/25/2015 4035CB8304CA4M... Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dsrlisr, d ,eotylic, )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