R 2016-334-E Aging - Karen Weaver for wellness instructor

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DocuSign Envelope ID:CBDDBOD4-638F-4858-B1CO-658703A5379C ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Karen Weaver Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: 431 Hampton Pointe Blvd City Hillsborough State: NC Zip: 27278 Department: Aging Amount: $1,500 Purpose: Wellness Instructor Budget Code(s): 29430320-630000 Vendor#63615 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective Date July 1,2016 Approved by Board Yes❑ No® Agenda Date: This agreement is approved as to technicgl farm and content: ocu igne by: Department Director's Signature J 1U_ - �,r Date: 6/28/2016 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: Fms&DocuSignedby:'ll Office of the Risk Management Officer (hnutl6 Date: 6/29/2016 7FDCF9176800498... Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: F��N o cuSigned by. Office of the Chief Financial Officer 0°" &. Date: 7/5/2016 7D4E5181ACC1409... Legal Services This agreement is approved as to legal form and sufficiency: igned by: DocuS Office of the County Attorney Date: 7/6/2016 4035CB8304CA4A9... Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloydgoran eg countync•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 6/16 5