R 2015-374-E Aging - Kathleen Hammon for wellness instructor

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DocuSign Envelope ID: D3A3FB7C-F3D5-4390-A335-E1 D1DF068BE6 r i i ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Kathleen Hammon Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: 1102 E Franklin Street City Chapel Hill State: NC Zip: 27514 Department: Aging Amount: $4,000.00 f Purpose: wellness instructor Budget Code(s): 10430120-770105 Vendor#56311 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No❑ Contract Type: (Check one)New❑ Renewal ® Amendment ❑ Effective Date July 20,2015 Approved by Board Yes❑No❑ Agenda Date: I This agreement is approved as to technical form and content: DocuSigned by: Department Directors Signature , O,JA,. fi Date: 7/16/2015 B7E962D1BF454FA._ Information Technologies c (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: i E. Risk Management { k This agreement is approved for sufficiency of insurance standards,specifications,and requirements: DocuSigned by: Office of the Risk Management Officer Aura, r,6�0 Date: 2/19/2015 7FDCF9176800498... Financial Services This instrument has been pre-audited in the ffililn,e.Ipyquired by the Local Government Budget and Fiscal Control Act: [:! Office of the Chief Financial Officer �A blti Date: 7/28/2015 232DFFC2CFA847B... I f Leal Services This agreement is approved as to le aI form and sufficiency: r' ocuSigned by: Office of the County Attorney Date: 2/28/2015 4035CB8304CA4A9... Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@oran eg coup nc,gov 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