R 2016-519-E Aging - Rena Springer for wellness instructor

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DocuSign Envelope ID:8C7A270E-432E-42E0-A5B7-5136E53010EC ORANGE COUNTY-DEPARTMENT USE ONLY Department Party/Vendor Name: Rena Springer Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: 1101 Exchange Place, #838 City Durham State: NC Zip: 27713 Department: Aging Amount: $1,200 Purpose: Wellness Instructor Budget Code(s): 29430320-630000 Vendor#611218 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ® Amendment ❑ Effective Date September 12,2016 Approved by Board Yes❑ No® Agenda Date: This agreement is approved as to technical form and content: DocuSigned by: Department Director's Signature � 1GL :�'r Date: 9/8/2016 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: DocuSigned by: ffi Office of the Risk Management Ocer aUSA rbvvut 1'_ 'll 6 Date: 9/8/2016 7FDCF9176800498... Financial Services This instrument has been pre-audited in the manner r�Vuired by the Local Government Budget and Fiscal Control Act: DocuSigned Office of the Chief Financial Officer � °" a°9Z Date: 9/8/2016 Os 7D4E5181ACC1409... Legal Services This agreement is approved as to legal form and sufficiency: DocuSigned by: Office of the County Attorney Date: 9/9/2016 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