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DocuSign Envelope ID:9F4A8CF5-2029-449B-A53F-956739F1CFD7 <br /> ORANGE COUNTY—DEPARTMENT USE ONLY <br /> Party/Vendor Name: Matrix Health & Safety Consultants, LLC. Party/Vendor Contact Person: C. Britt Wester, <br /> CIH Contact Phone: 919-833-2520 Party/Vendor Address: 2900 Yonkers Road City Raleigh State: NC Zip: <br /> 27604 Department: H&CD Amount: Up to $13,000.00 Purpose: Lead and Asbestos Test for Housing <br /> Rehabilitation Units Budget Code(s): 32470320 630000 Vendor#N/A (N/A if new vendor) Vendor is a BOCC <br /> consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑ Amendment ❑ Effective Date <br /> 09/25/2019 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 <br /> on this project has not been initiated prior to execution of the agreement: <br /> DocuSigned by: <br /> 9/18/2019 <br /> Department Director's SignatureVgoo9E01771409 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 /> 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, DocuSi9ned by: S, specifications,and requirements: <br /> §US . (,DV1n.t,{�6 9/30/2019 <br /> Office of the Risk Management Officer 7FDC F91 76800498. Date: <br /> Financial Services <br /> This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control <br /> Act: DocuSigned by: <br /> A.&I. 9/30/2019 <br /> Office of the Chief Financial Officer Date: <br /> 704E51S1ACC1409. <br /> Legal Services <br /> This agreement is approved as to 1 bocusigned bv: -- f Date:- <br /> Office of the County Attorney <br /> �Inux, �-ayi, l vS(h 9/30/2019 <br /> _ <br /> 079A4D525COF4Fg. <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 />