R 2016-377-E Aging - Return 2 Recess for wellness instructor

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DocuSign Envelope ID:61058E40-1A9C-468F-A21D-D525A55FD8DB ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Return 2 Recess Party/Vendor Contact Person: Kim Saffran Contact Phone: 919-599-4696 Party/Vendor Address: P O Box 106 City Carrboro State: NC Zip: 27510 Department: Aging Amount: $1,500 Purpose: Wellness Instructor Budget Code(s): 29430320-630000 Vendor# (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 technic4 fQ n .content: DDepartment i 4FA Director's Signature Date: 7/19/2016 Information Technolosies (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: Docu5igned""by: ''11i1 Office of the Risk Management Officer Pausa, (,6rvu,�16 Date: 7/19/2016 7FDCF9176800498... Financial Services This instrument has been pre-audited in th � jd�,�quired by the Local Government Budget and Fiscal Control Act: 7/20/2016 Office of the Chief Financial Officer r `�°'�" �°'v Date: 7D4E5181ACC1409... Legal Services This agreement is approved as to legal form and sufficiency: ocuSigned by: Office of the County Attorney E��EK Date: 7/20/2016 4035CE8304CA4A9... Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloy(d c�orangecount.nic.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