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DocuSign Envelope ID: EFA046A9-1DCB-4ED7-98BA-B96A823B3D45 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Axiom Environmental, Inc. Party/Vendor Contact Person: Alexander Smith; Contact Phone: <br /> 919-270-9306 Party/Vendor Address: 218 Snow Ave. City Raleigh State: NC Zip: 27603 Department: DEAPR <br /> Amount: 2,292.00 Purpose:Environmental Work Budget Code(s): 61370035 880000 20037 Vendor#65665 (N/A if <br /> new vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ <br /> Amendment ❑ Effective Date 5/22/2019 Approved by Board Yes❑No® Agenda Date: <br /> This agreement is approved as to technical form and content and I as Department Director affirmatively state work on <br /> this project has not been initiated prior to execution of the agreement: <br /> DocuSignedd by: <br /> Department Director's Signatu e 10 �fay�.ctl, Date:5/21/2019 <br /> Agreements for emergency service VL$ft1QW64hbt 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 was <br /> addressed: <br /> Information Technologies <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 /> Office of the Chief Information Officer Date: <br /> Risk Management <br /> This agreement is approved for sufficiency of insurance standards, specifications,and requirements: <br /> FDocuSigned by: <br /> rausa,Office of the Risk Management Offic 6606 Date: 5/22/2019 Ds <br /> 7FDCF9176800498... <br /> Financial Services <br /> This instrument has been pre-audited in t1le Nann�e�r required by the Local Government Budget and Fiscal Control Act: <br /> ocu Igoe y: <br /> Office of the Chief Financial Offic (�" 0.&1. Date:5/22/2019 <br /> 7D4E5181ACC1409... <br /> Legal Services <br /> This agreement is approved as to le lufso9md%Vd sufficiency: <br /> ^�� ��� 5/23/2019 <br /> Office of the County Attorney J Date: <br /> EAA3D33ED8A8465... <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 4 <br />