R 2017-280-E Aging - Daniel Leonard for wellness instructor

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DocuSign Envelope ID:Dl5A8E35-8D90-4C51-A263-4DFF97E02A3A ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Daniel Leonard Party/Vendor Contact Person: Contact Phone: Party/Vendor Address: 105 Keith Road City Carrboro State: NC Zip: 27510 Department: Aging Amount: $6,000 Purpose: Wellness Instructor Budget Code(s): 29430320-622000 Vendor#44504 (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: Department Director's Signature i'a/utu, tii(as Date: 7/9/2017 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: aLtS& Cb b 7/10/2017 Office of the Risk Management Officer Date: 7FDCF9176800498... Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: -- f —DocuSigned by. Office of the Chief Financial Officer rI 4441'6."1- Date: 7/10/2017 —7D4E5181 ACC1409... Legal Services This agreement is approved as to legal gorr1�,anal sufficiency: ocu igne by:♦�-�� atAAAA, ova AYtt, 1 o 7/10/2017 Office of the County Attorney Date: 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