R 2015-361-E Aging - Alicia Reid for wellness instructor

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DocuSign Envelope ID: 165D3B4D-D069-4060-B893-CE23BF8F28D4 ORANGE COUNTY—DEPARTMENT USE ONLY Deuartment Party/Vendor Name: Alicia Reid Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: 3508 Borland Road City Efland State: NC Zip: 27243 Department: Aging Amount: $990.00 Purpose: Wellness Instructor Budget Code(s):29430320-630000 Vendor 4 62881 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective Date July 28, 2015 Approved by Board Yes❑No❑ Agenda Date: This agreement is approved as to technicp1 f rm nd content: 6o p cu�igned"by: �� '�`b (r 7/27/2015 Department Director's Signature Date: 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: PUS.DocuSigned""by:''1L g rbvvte tt0 7/27/2015 Office of the Risk Mana ement Officer Date: 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 AU� l(1-bvu Date: 7/28/2015 232DFFC2CFA847B... Legal Services This agreement is approved as to 1 f rm b�ppd sufficiency: �ocu�ignedby: Office of the County Attorney Date: 7/28/2015 ... 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