R 2018-348 Emergency Svc - Penta Engineering Special Testing 3800 Hwy 70

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DocuSign Envelope ID: 3EFOFF2D- AE78- 42B5- B6CA- 82C97781C16E GRANGE COUNTY - DEPARTMENT USE ONLY Department PartyNendor Name: Penta Engineering Group Inc Party /Vendor Contact Person: Dan D. Blair Jr, PE Contact Phone: 419.455.0212 PartyNendor Address: 4000 Miller Court West City Norcross State: GA Zip: 30071 yr Department: AMS Amount: $2000.00 Purpose: Asbestos & head Testing_for_3800 Hwy 70 Propegy, Efiand NC Budget Code(s): 61370035 - 870000- 10053 Vendor # 61470 (N /A if new vendor) Vendor is a BOCC consultant? Yes ❑ NoM Contract Type: (Check one) New 0 Renewal ❑ Amendment ❑ Effective Date 5/21/2018 Approved by Board Yes❑ No® Agenda Date: This agreement is approved as to technical form and content: Department Director's Signature �i+^-��s _ Date: 7/30/2018 Information Technologies (Applicable only to hardware/sofrtvare purchases or related services) This agreement has been reviewed and is approved as to information technology content and specifications: Office of the Chief Information Officer Risk Mana &ement Date: This agreement is approved for sufficiency of insurance standards, specifications, and requirements: a. Office of the Risk Management Office d-- ba� a Financial Services Date: 8/1/2018 This instrument has been pre - audited in the manner required by the Local Government Budget and Fiscal Control Pt Act: Office of the Chief Financial Officer � bate: 8/1/2018 �� f.. =.i P1 A(:C,�1(P Legal Services This agreement is approved as to legal form and sufficiency: Office of the County Attorney l� .lawfs _ _ Date:8/7/2018 Clerk to the Board Received for record retention: All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll @oran eg cou tync.gov The following signature block is for hard copies only and is not required for Docusign contracts: Office of the Clerk to the Board Revised 10117 Date: