R 2015-294-E Aging - Nancy Alton for Fitness Studio Management

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DocuSign Envelope ID:60F8978A-A70B-42DE-91 DB-31313E5E1 F71 D ORANGE COUNTY—DEPARTMENT USE ONLY Deuartment Party/Vendor Name: Nancy Alton Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: 3917 Marklyn Place City Hillsborough State: NC Zip: 27278 Department: Aging Amount: $6,000.00 Purpose: Fitness Studio Management Budget Code(s): 10430120-630000-71085 Vendor 4 58145 (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: 6/23/2015 Department Director's Signature � « fi� Date: 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: '' 11LL Office of the Risk Management Officer �,Sa ('bn e& Date: 6/24/2015 7FDCF9176800498... Financial Services This instrument has been pre-audited in lagj uired by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer PMAL h aw Date: 6/24/2015 232DFFC2CFA847B... Legal Services This agreement is approved as to le alofg�y gn��ysufficiency: Office of the County Attorney ✓ 0 1� Date: 6/29/2015 4035CB8304CA4A9... 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