R 2015-324-E Aging - William Meyers for wellness instructor

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DocuSign Envelope ID:6EE6AC2A-3229-41 BE-821D3-E6131 0713201A2 ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: William Mew Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: 1204 little Creek Road City Durham State:NC Zip: 27713 Department: Aging Amount: 1,500.00 Purpose: wellness instructor Budget Code(s): 29430320-630000 Vendor# 56366 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New ❑ Renewal ® Amendment ❑ Effective Date Jul�l, 2015 Approved by Board Yes❑No❑ Agenda Date: This agreement is approved as to technical form and content: DocuSigned by: ' ,�a�,iu- - � Date: 7/7/2015 Department Director's Signature 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: Docu Signed by: Office of the Risk Management Officer Q�iS u r,6V17t t 0 Date: 7/7/2015 7FDCF9176800498... Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: DocuSigned y: Office of the Chief Financial Officer blti Date: 7/7/2015 232DFFC2CFA847B... Legal Services i This agreement is approved as to le a�fo lgnaid:sufficiency: ocu i Office of the County Attorney Date: 7/7/2015 4035CB8304CA4A9... Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@oran eg countync•gov 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