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DocuSign Envelope ID:33CDD006-3D88-494A-906F-4B74BDE05128 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Environmental Solutions Group, LLC Party/Vendor Contact Person: Dan Whittaker, <br /> (dwhittaker(d)Ro-ese 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: $25,000 Purpose: Perform <br /> Air and Surface sampling at the John Link Jr. Government Services Building through out pre &post construction.. <br /> Budget Code(s): 61370035 870000 10069 Vendor#65016 (N/A if new vendor) Vendor is a BOCC consultant? <br /> Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date 4/8/19 <br /> Approved by Board Yes®No❑ Agenda Date: April 2,2019 <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 /> QLt, �/anx 4/11/2019 <br /> Department Director's Signature[IX, Date: <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 �#f° Date a/11/zo19 <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> P( Act: <br /> Office of the Chief Financial Officer e' -N "' Date:4/15/2019 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> Office of the County Attorney �'�"` ° Date:4/16/2019 <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 />