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DocuSign Envelope ID:AD43A22F-6754-4919-9754-D100376EF19E <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: New River Tire Recycling, LLC Party/Vendor Contact Person: Ben Bryant Contact Phone: <br /> Party/Vendor Address: P.O. Box 1752 City Pilot Mountain State: NC Zip: 27041 Department: Solid <br /> Waste Amount: 100,000 annually, 500,000 during initial term and 1.1 million over term and renewal period <br /> Purpose: Loading, Transporting, and Recycling or Disposal of Scrap Tires Budget Code(s): 50352020-630003 <br /> Vendor# (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract Type: (Check one) <br /> New® Renewal ❑ Amendment ❑ Effective Date June 1,2017 Approved by Board Yes No Agenda <br /> Date:May 2,2017 <br /> This agreement is approved as to technical form anti content: <br /> r----DocuSigned y: <br /> Department Director's Signature al,titt, Maw Date: 5/11/2017 <br /> 6E763F604A144E2... <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 /> r----DocuSiggned by: <br /> Office of the Risk Management Officer <br /> aUS a' Cbb Date: 5/11/2017 <br /> `'*• 7FDCF9176800498... <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 Date: 5/16/2017-7D4E5181 ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and.sufficiency: <br /> , _ g by: <br /> jA t,S br Ait, 5/16/2017 <br /> Office of the County Attorney � Date: <br /> �—328DC480549A4F5... <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd @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 2/17 9 <br />