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DocuSign Envelope ID: F08B1 D96- 60E5 -45AD- 8055- 70EAF07C320F <br />ESt3 tnvironmeniai ,>oiuuons croup <br />Leading people, companies and communities to live, <br />work and prosper in a sustainable environment. <br />Please review the information on your project for accuracy and let us know of any changes that need to be made. If <br />the information provided is accurate, please sign and return this authorization form to our office. If no signed <br />service agreement is delivered, we will consider your appointment canceled. The assessment must be canceled 24 <br />hours in advance otherwise, a $50.00 fee will be incurred. Payment is due at the time of service. <br />Assessment: <br />Name /Company Angel Barnes /Orange County Government <br />Email <br />abarnes @orangecountync.gov <br />Phone <br />919 - 245 -2628 <br />Description <br />2 full site assessments <br />Address <br />Mebane NC <br />Date of Project <br />TBD <br />Time <br />TBD <br />Billing <br />$50.00 <br />Name /Company <br />ATTN Angel Barnes <br />Billing Address <br />131 West Margaret Lane, Hillsborough NC <br />Email <br />SAME <br />Phone <br />SAME <br />Pricing: <br />$2,400.00 <br />Service: <br />Unit <br />Quantity <br />Price <br />Board of Elections Building <br />Full site assessment <br />$550.00 <br />1 <br />$550.00 <br />Air /surface sample* <br />$50.00 <br />37 <br />$1,850.00 <br />*bulk pricing <br />ESTIMATED TOTAL: <br />$2,400.00 <br />Service: <br />129 E King Street <br />Full site assessment <br />$475.00 <br />1 <br />$475.00 <br />Air /surface sample* <br />$50.00 <br />25 <br />$1,250.00 <br />*bulk pricing <br />ESTIMATED TOTAL: <br />$1,725.00 <br />Please note that the above number of samples is estimated. Actual sample numbers could increase or decrease <br />based on conditions observed during the site visit. Any additional samples will be approved by the client prior to <br />payment. Lab results will be communicated within 48 hours of the site assessment. The report will be released <br />within 7 -9 business days following the assessment and payment in full. <br />Scope of Work: ESG, LLC has been requested to perform the scope of work as listed on the following pages of this <br />document. <br />Work Authorized By: <br />Signatory warrants his /her authority to bind the entity represented and pay the above price in full. <br />Signature: Date: <br />Print Name: Title: <br />ESG Representative: _ <br />Virginia Whittaker, CEO <br />�� V�- L <br />Date: 312118 <br />• 1000 N. Elm St., Greensboro, NC 27401 • Phone: 336 - 373 -1538 • Fax: 877 - 222 -2348 • www.Go- ESG.com <br />