R 2015-329-E Aging - Martha Broda for wellness instructor

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DocuSign Envelope ID:66806383-C635-48A3-B408-7BC6C50D832B ORANGE COUNTY-DEPARTMENT USE ONLY Department Party/Vendor Name: Martha Broda Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: 1388 Manus Chapel Road City Pittsboro State: NC Zip: 27312 Department: Aging Amount: $2,000.00 Purpose: wellness instructor Budget Code(s): 29430320-630000 Vendor 4 58627 (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 technicaj fob aid content: '�` Department Director's Signature � Date: 7/8/2015 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 allStU (hVV,&b Date: 7/9/2015 7FDCF9176800498... Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: DocuSigned by: Office of the Chief Financial Officer P ( Date: 7/9/2015 au�, 1AU "'blA, 232DFFC2CFA847B... Legal Services This agreement is approved as to legal form and sufficiency: DocuSigned by: Office of the County Attorney � , Date: 7/9/2015 """��•••.. 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