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DocuSign Envelope ID:4F777F78-922F-43C2-A26A-E4F2744C E FEB <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: Agri-Waste Technology,Inc. Party/Vendor Contact Person: Chris McGee Contact Phone:(`U9 <br /> 367-63 16 Party/Vendor Address: 501 N. Salem St.,Suite 203 City Apex State:NC Zip: 27502 Department: DEAPR <br /> Amount: $1,800 Purpose: Soil testing for septic system Budget Gode(s): 61370035 860000 20003 Vendor# 61546 <br /> (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑No® Contract Type: (Check one)New ® Renewal <br /> ❑ Amendment ❑ Effective Date July 1.2019 Approved by Board Yes❑No® Agenda Date:N/A <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 /> QocuSigned by: <br /> Department Director's Signature PAVL(I Sfoai� Date:7/5/2019 <br /> Agreements for emergency services or repair are s11CFA1Q507Aa95. iVe affumatinn. If SerV1CC5 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 hardwarelsoftware 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 /> WcuSigned by: <br /> �1_ . <br /> Office of the Risk Management Officer aUSX 1 p,41WA 6 Date: 7/5/2019 <br /> 7FQCF9176900498. <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> DocuSigned by: <br /> Office of the Chief Financial Officer A .&I . Date: 7/5/2019 <br /> 7NE5181ACC1400 <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> UocuSigned by: <br /> Office of the County Attorney , xm(,S aU, Date:7/5/2019 <br /> 323QC48054eA4F5.. <br /> Clerk to the Board <br /> Received for record retention: <br /> All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@orangecountyne.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 />