R 2017-256-E Aging - Arlene Bynum-Mills for fitness studio management

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DocuSign Envelope ID:Al5B6B22-02AD-40AD-A037-154629882875 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: $7,000 Purpose: Fitness Studio Management Budget Code(s): 10430120-630000-71085 Vendor # 64460 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective Date 7/01/17 Approved by Board Yes No Agenda Date: This agreement is approved as to technical form and content: /^--DocuSigned by: 6/29/2017 Department Director's Signature JalAA L- ItiILt�V Date: 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 Yby:'ll g ill rbIv U 6/29/2017 Office of the Risk Management Officer Date: 7FDCF9176800498... Financial Services This instrument has been pre-audited inthe �annerdrequired by the Local Government Budget and Fiscal Control Act: Office of the Chief Financial Officer (1'161 ` °" a°9Z Date: 6/30/2017-7D4E5181 ACC1409... Legal Services This agreement is approved as to legal form and sufficiency: p--DocuSigned by: Office of the County Attorney atAAA t, hark, 1 sco Date: 7/2/2017 `—079A4D525C0F4FB... 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