R 2017-199-E Aging - Arlene Bynum-Mills for wellness instructor

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DocuSign Envelope ID:D60198FD-0622-47EC-9846-C5E0B99AC13C ORANGE COUNTY-DEPARTMENT USE ONLY Department Party/Vendor Name: Arlene Bynum-Mills Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: 213 Rosaline Lane City Durham State: NC Zip: 27713 Department: Aging Amount: $400.00 Purpose: Wellness Instructor Budget Code(s): 10430120-770105 Vendor#64460 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No Contract Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date 5/01/17 Approved by Board Yes No Agenda Date: This agreement is approved as to technical form and content: /^--DocuSigned by: ou ^ iu, 'r� Department Director's Signature J Date: 5/25/2017 s 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: r----DocuSigned by: ""� ''��. 5/30/2017 Office of the Risk Management Officer ausa rtAA 116 Date: ``,. 7 FDC F9176800498... Financial Services This instrument has been pre-audited in the manneigned r requby: ired by the Local Government Budget and Fiscal Control Act: ocu Office of the Chief Financial Office 5/30/2017 �a 0°". a°'z Date: 7D4E5181 ACC1409... Legal Services This agreement is approved as to legalpforz g auplysufficiency: Office of the County Attorney a '1' L to Date: 5/31/2017 \^—079A4D525COF4FB... 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 2/17 5