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Revised 10/17 <br />8 <br />ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br />Department <br /> <br />Party/Vendor Name: Penta Engineering Group, Inc Party/Vendor Contact Person: Dan D. Blair Jr, PE Contact <br />Phone: 919.455.0212 Party/Vendor Address: 4000 Miller Court West City Norcross State: GA Zip: 30071 <br />Department: AMS Amount: $2950.00 Purpose: Asbestos & Lead Testing for Government Services Annex Budget <br />Code(s): 61370035-870000-10008 Vendor # 61470 (N/A if new vendor) Vendor is a BOCC consultant? Yes <br />No Contract Type: (Check one) New Renewal Amendment Effective Date 5/21/2018 Approved by <br />Board Yes No Agenda Date: <br /> <br />This agreement is approved as to technical form and content: <br /> <br />Department Director’s Signature ________________________________________ Date: ________ <br /> <br /> <br />Information Technologies <br /> <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 /> <br />Office of the Chief Information Officer___________________________________ Date: ________ <br /> <br /> <br />Risk Management <br /> <br />This agreement is approved for sufficiency of insurance standards, specifications, and requirements: <br /> <br />Office of the Risk Management Officer___________________________________ Date: _________ <br /> <br /> <br />Financial Services <br /> <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br />Act: <br /> <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br /> <br /> <br />Legal Services <br /> <br />This agreement is approved as to legal form and sufficiency: <br /> <br />Office of the County Attorney __________________________________________Date: ________ <br /> <br /> <br />Clerk to the Board <br /> <br />Received for record retention: <br />All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@orangecountync.gov <br />The following signature block is for hard copies only and is not required for Docusign contracts: <br /> <br />Office of the Clerk to the Board __________________________________________Date:_________ <br /> <br /> <br /> <br />DocuSign Envelope ID: 8967D249-0449-4C9F-8B6B-F8BEA1741F74 <br />In ProcessRisk ManagementRisk Managemento <br />DocuSign Envelope ID: 8967D249-0449-4C9F-8B6B-F8BEA1741F74 <br /> <br /> <br /> <br />