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DocuSign Envelope ID:4D07A756-4236-4526-A1 D2-89F0777755FB <br /> I4 11 u1 III10 l 1 @i0J1 1 rrrr� 11 t r 11 II 11 11 r /11, 11 I <br /> 11 1100 <br /> oll o1 11111111111 11111111111111111 <br /> PROPOSAL ACCEPTANCE FORM <br /> ECS SOUTHEAST, LLP <br /> (Moose Fu lin a�u iype) <br /> Project Name: Orange County Jail <br /> Location: 125 Court Street, Hillsborough, Orange County, North Carolina <br /> Est. Amount: Geotechnical-$6,550.00 Private Utility Location: $900.00 (initial if requested) <br /> Phase I ESA-$2,100.00 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 Government. <br /> Your signature also indicates you have read this document and the Terms&Conditions of Service in <br /> their entirety and agree to pay for services as above set forth. <br /> CLIENT AND BILLING INFOII MATION <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 aplankford @ecslimited.com or fax to <br /> (919)861-9911. <br /> 11)e /1,1J ,IJ <br /> ll. <br /> rlr , <br /> Il llllllllllU Ullll Ulll <br />