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DocuSign Envelope ID: D5386F95-C7D7-4467-802E-832D3E20CE67 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: S&ME Party/Vendor Contact Person: Samuel P. Watts Contact Phone: 919-872-2660 <br /> Party/Vendor Address: 3201 Spring Forest Road City Ralei State: NC Zip: 27616 Department: DEAPR <br /> Amount: $28,000.00 Purpose: Groundwater Sampling at Former Hillsborough Landfall Budget Code(s): 61370035 <br /> 870000 20041 Vendor# 52307 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract <br /> Type: (Check one)New ® Renewal ❑ Amendment ❑ Effective Date April 19, 2019 Approved by Board <br /> Yes❑No® Agenda Date: <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 /> DocuSigned by: <br /> Department Director's Signature 11)AVL(I S �� Date: 4/9/2019 <br /> Agreements for emergency services or repair are n( 911cFA1DK7A495. e 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: <br /> Risk Manaff—cment <br /> This agreement is approved for sufficiency of insurance standards,specifications, and requirements: <br /> DocuSigned by: <br /> Office of the Risk Management Officer 9US& cbvin.th Date:4/10/2019 <br /> 7FDCF9176800498. <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 /> DocuSigned by: <br /> Office of the Chief Financial Officer Date: 4/15/2019 <br /> 7NE5181ACC1400 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> DocuSigned by: <br /> Office of the County Attorney ,� t.S aU, Date: 4/15/2019 <br /> 323DC4H54eA4F5.. <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: snngersoll@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 /> 9 <br />