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DocuSign Envelope ID:ODA693AE-42FA-4050-AF6B-FF541405DO33 <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Joy Gornto Party/Vendor Contact Person: Contact Phone: Party/Vendor <br /> Address: 3431 Pickett Rd City Durham State: NC Zip: 27705 Department: Aging Amount: $12,000 Purpose: <br /> Wellness Instructor Budget Code(s): 29430320-630000 Vendor # 61228 (N/A if new vendor) Vendor is a <br /> BOCC consultant? Yes ❑ No❑ Contract Type: (Check one) New ❑ Renewal ® Amendment ❑ Effective <br /> Date 07/01/2019 Approved by Board Yes❑Nor-1 Agenda Date: <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work <br /> on this project has not been initiated prior to execution of the agreement: <br /> DocuSigned by: <br /> Department Director's Sig, �Aan.iGt, -['+��W Date: 7/18/2019 <br /> Agreements for emergency service B7E9szD,BF454FA.. eject to the above affirmation. If services related to this <br /> agreement have already begun or been completed please briefly describe the nature of the emergency condition that <br /> was addressed: <br /> Information Technologies <br /> (Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is <br /> approved as to information technology content and specifications: <br /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards,specifications,and requirements: <br /> DocuSigned by: <br /> Office of the Risk Management Officer �U56 (h4 6 Date: 7/19/2019 <br /> 7FDCF9176900498. <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Officer <br /> 4 Date: 7/22/2019 <br /> 704E5981ACC1409. <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorney �,o I Date: 7/24/2019 <br /> 4035CB8304CA4Ae <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@orangecountync.gov <br /> The following signature block is for hard copies only and is not required for Docusign contracts: <br /> Office of the Clerk to the Board Date: <br /> Revised 12/18 <br /> 8 <br />