R 2017-007-E DEAPR - Jason Zwilling for capoeira instruction

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DocuSign Envelope ID:33BFD31A-E737-40B5-BF7E-75FBB1B8AFAD ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Jason Zwilling Party/Vendor Contact Person: Jason Zwilling Contact Phone: 917-790-9685 Party/Vendor Address: 2406 Uphill Court City Hillsborough State: NC Zip: 27278 Department: DEAPR Amount: 1.417.50 Purpose: Capoeira Instruction Budget Code(s): 10511020-630000 Vendor # n/a (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 1/1/2017 Approved by Board Yes❑No Agenda Date: This agreement is approved as to to Tr prd content: 'lq 1/6/2017 Department Director's Signature 611CFA1D507A495... Date: 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 sufficient /m u r� acystandards, specifications,and requirements: QUSA. COVIA.06 1/8/2017 Office of the Risk Management Officer 7F Date: Financial Services This instrument has been pre-audited i eD(Iii11V f it by the Local Government Budget and Fiscal Control Act: 1/11/2017 Office of the Chief Financial Officer Date: 7D4E5181ACC1409... Legal Services This agreement is approved as tt -fl•cf8igtridattid�s,l'ufficiency: b leb�•w 1/11/2017 Office of the County Attorney ,, ,,,,,,,,Sq Date: Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd@orangecountync.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 r CDS s