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DocuSign Envelope ID:800D8824-FA55-4AFE-9F41-84305E3BCA56 <br /> January 7,2016 0 ECS CAROLINAS, LLP <br /> PROPOSAL ACCEPTANCE FORM <br /> ECS CAROLINAS, LLP <br /> (Please Print or Type) <br /> Project Name: Proposed Library Site <br /> Location: 203 South Greensboro Street, Carrboro, Orange County, North Carolina <br /> Est. Amount: Geotechnical-$4,650.00 Private Utility Location: $900.00 (initial if requested) <br /> Phase I ESA-$1,900.00 Lien Search Fee: $250.00 (initial if requested) <br /> Please complete and return this Proposal Acceptance Form to ECS as shown at the bottom of this form. <br /> By signing and returning this form,you are authorizing ECS to proceed, providing ECS permission to <br /> enter the site, and making this proposal the agreement between ECS and Orange County Asset <br /> Management& Purchasing. Your signature also indicates you have read this document and the Terms <br /> & Conditions of Service in their entirety and agree to pay for services as above set forth. <br /> CLIENT AND BILLING INFORMATION <br /> Name of Client: <br /> Contact Person: <br /> Telephone No. <br /> E-mail: <br /> Responsible for Payment Approval of Invoice(if different) <br /> Contact Name: <br /> Company Name: <br /> Address <br /> Address <br /> City, State,Zip <br /> Telephone No.: <br /> Fax No: <br /> E-mail Address: <br /> Reports are normally e-mailed directly to client. If you require copies to others, please provide their <br /> names, e-mail addresses, and fax numbers below. <br /> Name e-mail Address Phone Number Fax Number <br /> Special Instructions: <br /> Client Signature: X Date: <br /> Please return signed Proposal Acceptance Form to Aubrey Lankford at a plan kfordCcDecslimited.com or fax to <br /> (919)861-9911. <br /> D <br /> ECS Proposal Nos. 06:19462 and 06:19463 Page 18 <br /> O'" <br />