Orange County NC Website
DocuSign Envelope ID:8C7A270E-432E-42E0-A5B7-5136E53010EC <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Rena Springer Party/Vendor Contact Person: Contact Phone: Party/Vendor <br /> Address: 1101 Exchange Place, #838 City Durham State: NC Zip: 27713 Department: Aging Amount: $1,200 <br /> Purpose: Wellness Instructor Budget Code(s): 29430320-630000 Vendor#611218 (N/A if new vendor) Vendor is <br /> a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ® Renewal ® Amendment ❑ Effective <br /> Date September 12,2016 Approved by Board Yes No Agenda Date: <br /> This agreement is approved as to technical form and content: <br /> r^--DocuSigned by: <br /> Department Director's Signature i tAGt- �i� t V Date: 9/8/2016 <br /> B7E962D1BF454FA... <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)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: <br /> r^--DocuSigned by: <br /> Office of the Risk Management Officer 1tttSA rbvvut'_ 'll 16 9/8/2016 <br /> Date: <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> r---DocuSigned <br /> Office of the Chief Financial Officer rI 446°9Z Date: 9/8/2016-7D4E5181 ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> r---DocuSigned by: <br /> Office of the County Attorney Date: 9/9/2016 <br /> `—4035C B8304CA4A9... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd @orangecountync.gov <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 6/16 5 <br />