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DocuSign Envelope ID: EE36A5A6-7D04-4876-B67B-1CB28B880BC7 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Environmental Solutions Group, LLC Party/Vendor Contact Person: Dan Whittaker, <br /> (dwhittaker(a^go-es,g com) Contact Phone: 336-392-8526 Party/Vendor Address: 1000 N. Elm Street City <br /> Greensboro State: NC Zip: 27402 Department: AMS/Emergency Services Amount: $10,000 Purpose: Perform <br /> Air and Surface sampling at the 510 Meadowlands buildingthrough hrough out construction as post remediation verfication <br /> testing. Budget Code(s): 61370035 870000 10068 Vendor # 65016 (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date <br /> 2/6/19 Approved by Board Yes®No❑ Agenda Date:February 5,2019 <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work <br /> on this project has not been initiated prior to execution of the agreement: <br /> Department Director's Signature vi,.L s Date:3/6/2019 <br /> Cs� <br /> Agreements for emergency services or repair are not subject to the above affirmation. If services related to this <br /> agreement have already begun or been completed please briefly describe the nature of the emergency condition that <br /> was addressed: N/A <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards, specifications,and requirements: <br /> Office of the Risk Management Office kGs� �a�r#f° Date: 3/7/zo19 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: <br /> P� 3/11/2019 <br /> Office of the Chief Financial Officer Date: <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Office of the County Attorney Date:3/11/2019 <br /> Clerk to the Board <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 /> Office of the Clerk to the Board Date: <br /> Revised 12/18 <br />