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DocuSign Envelope ID:813A5323-29B6-4DDD-A2B8-22B7F4A4A68C <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Department <br /> Party/Vendor Name: Clean Harbors Party/Vendor Contact Person: Gwen Hill Contact Phone: 339-788-1037 <br /> Party/Vendor Address: 208 Watlington Dr City Reidsville State: NC Zip: 27230 Department: Solid Waste Amount: <br /> 240,000 per yr, total 480,000 Purpose: Household Hazardous Waste collection and disposal Budget Code(s): <br /> 50352020630003 Vendor# 61437 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No Contract <br /> Type: (Check one) New ❑ Renewal ® Amendment ® Effective Date July 1, 2017 Approved by Board Yes <br /> No Agenda Date:May 2,2017 <br /> This agreement is approved as to technical form and content: <br /> r----DocuSigned by: <br /> Department Director's Signature al,titt, Mbin, Date: 5/26/2017 <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---DocuSigned_by: <br /> Office of the Risk Management Officer t S& rbrin,'ll b Date: 6/5/2017 <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in the ma �rsreci�yed by the Local Government Budget and Fiscal Control Act: <br /> Office of the Chief Financial Officer Date: <br /> 6/19/2017 <br /> �aN ona,�am <br /> —7D4E5181 ACC1409... <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Office of the County Attorney ja,MGs 151nr Date: 6/19/2017 <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 jcb 05117 1 <br />