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DocuSign Envelope ID: E52B8315- AFE6- 4DB3- 8A28- FA045C18AA31 <br />Cnvuvnr M111di 3UMIM11b urvup <br />1 a.'MInq rreople, rrrmponles ono rommuni9 es 1 rr Nves <br />wrrrk and prrr ,p er in rr sup (('noble envirrrnrnrrV, <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 />abarnesoranecoun� nc.go�r <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 />Billin . <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 />Service: Unit Quantity Price <br />Board of Elections Building <br />Full site assessment $550.00 1 $550.00 <br />Air /surface sample* $50.00 37 $1,850.00 <br />*bulk pricing <br />ESTIMATED TOTAL: $2,400.00 <br />Service: <br />129 E King Street <br />Full site assessment $475.00 1 $475.00 <br />Air /surface sample* $50.00 25 $1,250.00 <br />*bulk pricing <br />ESTIMATED TOTAL: $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 />"J <br />ESG Representative: _ <br />Virginia Whittaker, CEO <br />Date: 312118 <br />@ 1000 Igo `t., Gi'eei,'isl�)oi' x, \4C 271,01 (o 1D'ioi'ie:..3("� �i: 73 1- "1)::8 (o 1 �o.: 877 2 21 2 ..4,8 Qk wvwltPlf.Go I_SG.coi'r <br />