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DocuSign Envelope ID:862A1C76-E42E-48F6-B579-DC059294685A <br /> DocuSign Envelope ID:401935FF-93EC-462C-9FB0-D487E3C12B7B <br /> r <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Daniel Leonard,R.N. Party/Vendor Contact Person: Contact Phone: Party/Vendor <br /> Address: 105 Keith Road City Carrboro State: NC Zip: 27510 Department: Aging Amount: $5,000.00 Purpose: t' <br /> wellness instructor Budget Code(s): 29430320-622000 Vendor# 58613 (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes ❑No❑ Contract Type: (Check one)New❑ Renewal ® Amendment ❑ Effective Date Jul�Ll <br /> 2015 Approved by Board Yes❑No❑ Agenda Date: <br /> This agreement is approved as to technicaloforxn and content; <br /> ocu igned y: <br /> Department Directors Signature <br /> �atn,tu �d V Date: 7/15/2015 <br /> B7E962D1BF454FA... <br /> Information Technoloeies <br /> (Applicable only to hard0are/softtvare purchases or related sewices)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: j <br /> I—Ausa,DocuSigned"by:' <br /> Office of the Risk Management Officer �,bvvt,e,f t 6 Date: 7/21/2015 <br /> l <br /> 7FDCF9176800498... <br /> i <br /> Financial Services <br /> This instrument has been pre-audited in the mg ulgneired by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer, �& Date: 7/22/2015 <br /> i <br /> 232DFFC2CFA847B... <br /> i <br /> Legal Services <br /> This agreement is approved as to=4035CB8304CA4Ag gufficiency: <br /> y <br /> Office of the County Attorney 7/22/2015 <br /> Date; <br /> ... <br /> i <br /> Clerk to the Board <br /> Recei ved for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd a�orangecountynagov <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 /> Revised 10/14 4 <br />