Orange County NC Website
Browse       Search
DocuSign Envelope ID:2D87994B-2BF5-4E42-BF79-7DA6E6324155 <br /> �4 <br /> DocuSign Envelope ID:DF7C6BB5-C031-4D40-A66D-493830D48532 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> h <br /> Department <br /> Party/Vendor Name: Janice Galloway, R.N. Party/Vendor Contact Person: Contact Phone: ; <br /> Party/Vendor Address: 6615 Glen Forest Drive City Chapel Hill State:NC Zip:27517 Department:Aging Amount: <br /> $6,000.00 Purpose: wellness instructor Budget Code(s): 29430320-622000 Vendor# 58613 (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❑Non Agenda Date: <br /> This agreement is approved as to tec [Wcfgi gbd content: <br /> ,tGt 'r 7/16/2015 <br /> Department Director's Signature Date: <br /> B7E962D1BF454FA... <br /> Information Technologies <br /> (Applicable only to hardware/softivare purchases or related services)This agreement has been reviewed and is <br /> i <br /> approved as to information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management I <br /> I <br /> E <br /> This agreement is approved for sufficiency of insurAnce standards,specifications,and requirements: <br /> Docu igned"by:' <br /> Office of the Risk Management Officer Q�1Sa �,bvvt e f t 0 Date: 7/19/2015 <br /> 7FDCF9176800498... <br /> t <br /> Financial Services <br /> This instrument has been pre-audited in P �QEer tired by the Local Government Budget and Fiscal Control Act: <br /> 7/20/2015 <br /> Office of the Chief Financial Officer �Adti� haw Date: <br /> 232DFFC2CFA847B... "" <br /> fi <br /> Legal Services <br /> This agreement is approved as to �die��d sufficiency: <br /> c; <br /> 7/20/2015 <br /> Office of the County Attorney "A Date: <br /> 4035CB8304CA4A9... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloynoran>ecotmtync.sov <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> Office of the Clerk to the Board Date: <br /> F <br /> Revised 10/14 4 <br />