Orange County NC Website
Browse       Search
DocuSign Envelope ID: E0415AA0-CF02-40B8-B47D-AE48574B8D5E <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Senie Wolfe Party/Vendor Contact Person: Contact Phone: Party/Vendor <br /> Address: 909 Pahners Grove Church Road City Hillsborough State: NC Zip: 27278 Department: Aging Amount: <br /> $1,500.00 Purpose: wellness instructor Budget Code(s): 10430120-770105 Vendor # 58051 (N/A if new vendor) <br /> Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one)New ❑ Renewal ® Amendment ❑ <br /> Effective Date July 1,2015 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> DocuSigned by: <br /> Department Director's Signature J A.bLtGt. � Date: /9/2015 ' <br /> B7E962D1BF454FA... <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is <br /> approved as.to information technology content and specifications: <br /> I <br /> Office of the Chief Information Officer Date: <br /> Risk M emen <br /> n <br /> a ag t <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> DocuSigned"by:' <br /> Office of the Risk Management Officer 5&4L r,6vt e& Date: 2/9/2015 <br /> 7FDCF9176800498... <br /> C' <br /> Financial Services <br /> F <br /> This instrument has been pre-audited in the qo,u 9�eAc�uu�ed by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer �A blti Date: 2/9/2015 <br /> 232DFFC2CFA847B... c <br /> Legal Services <br /> i <br /> This agreement is approved as to le atf2.�nggq,ysufficiency: <br /> Office of the County Attorney ✓� � Date: 2/9/2015 <br /> 4035CB8304CA4A9... <br /> t' <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@oran eg coun.nc._ov <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> k' <br /> Office of the Clerk to the Board Date: <br /> : <br /> i <br /> I <br /> Revised 10/14 4 <br /> L' <br />