R 2016-287-E Planning - Pilot Environmental, Inc. for Phase 1 Environmental Site Assessment

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DocuSign Envelope ID: DE50C3DC-2C59-4045-8605-848OD42217C5 ORANGE COUNTY—DEPARTMENT USE ONLY Department Party/Vendor Name: Pilot Environmental, Inc. Party/Vendor Contact Person: Michael Brame Contact Phone: (336) 708-4620 Party/Vendor Address: P.O. Box 128 City : Kernersville State: CA Zip: 27285 Department: Planning & Inspections Amount: $1,600,00 Purpose: Phase 1 Environmental Site Assessment Budget Code(s): 61370035-870000- 30044 Vendor#62512 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No[] Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 05/23/2016 Approved by Board Yes❑ No[] Agenda Date: N.A. This agreement is approved as to technical form and content: D Sig d by: Department Director's Signature (Yai� 130/u �d-� Date: 5/25/2016 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: D Sig d by: Office of the Risk Management Officer2"', Cb�b Date: 5/25/2016 Financial Services This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: D Sig d by: Office of the Chief Financial Office Date: 6/3/2016 Legal Services This agreement is approved as to legal form and sufficiency: DocuSigned by: Office of the County Attorne 16LVI I°o uw Date: 6/6/2016 EAA3D33ED8A8465... Clerk to the Board Received for record retention: All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd @orangecount,nc.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 1/16 4