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DocuSign Envelope ID:2560017F-D6E8-4CA4-8F6F-11521994BEAA <br /> ORANGE COUNTY-DEPARTMENT USE ONLY <br /> Party/Vendor Name: High Performance Building Solutions Party/Vendor Contact Person: Francis Conlin Contact <br /> Phone: 919-632-3595 Party/Vendor Address: 705 Watts Street City Durham State: NC Zip: 27701 Department: <br /> AMS Amount: $1200 Purpose: Link air and surface samples assessment Budget Code(s): 61370035-880000-10069 <br /> Vendor#N/A (N/A if new vendor) Vendor is a BOCC consultant? Yes❑No❑ Contract Type: (Check one)New <br /> ® Renewal❑ Amendment ❑ Effective Date 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 /> po UocuSigned by: <br /> Department Director's Signature Date:8/27/2019 <br /> Agreements for emergency services or re 092e9'-'VJa. ,)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: second opnion of surface and air samples at Link <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 /> UocuSigned by: ��tt <br /> Office of the Risk Management Officer aUS66 ('6 l 6 Date: 8/27/2019 <br /> 7FDCF9176900498. <br /> Financial Services Ep� <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> UocuSigned by: <br /> Office of the Chief Financial Officer r q 4 Date:8/27/2019 <br /> 7NE5181ACC1409. <br /> Legal Services <br /> This agreement is approved as to legal form and sufficiency: <br /> UocuSigned by: <br /> Office of the County Attorney ]EAAM3aED&AW5.. <br /> 6LW �bk� Date:8/28/2019 <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 4 <br />