R 2015-292-E Aging - Charron Andrews for wellness instructor

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DocuSign Envelope ID:9C6ODO4C-1EF6-4EOD-BD1A-7558114637A2 ORANGE COUNTY-DEPARTMENT USE ONLY Department Party/Vendor Name: Charron Andrews Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: 108 Cottonwood Ct. City Chapel Hill State: NC Zip: 27514 Department: Aging Amount: $990.00 Purpose: Wellness Instructor Budget Code(s): 29430320-630000 Vendor 4 38424 (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 ��«- �x Date: 6/29/2015 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[ a�ocu �,6vvt e tt0 Date: 6/29/2015 7FDCF9176800498... Financial Services This instrument has been pre-audited in the manner requi DocuSigned b red by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer blti Date: 6/29/2015 232DFFC2CFA847B... Legal Services This agreement is approved as to Z.7&I:sufficiency: Office of the County Attorney 1� Date: 6/29/2015 035CB8304CA4A9... 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