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ORANGE COUNTY—DEPARTMENT USE ONLY <br />______________________________________________________________________________ <br /> <br />Party/Vendor Name: Environmental Solutions Group, LLC Party/Vendor Contact Person: Dan Whittaker (dwhittaker@go- <br />esg.com) Contact Phone: 336.392.8526 Party/Vendor Address: 7 Maple Leaf Drive Ste 104 City Greensboro State: NC Zip: 27410 <br />Department: AMS Amount: This contract amendment is to increase the original contract amount by $20,000.00 (PO# 1901830) For a <br />new contract amount of $45,000.00 Purpose: This change amendment is to increase the air quality testing services for additional <br />testing, investigation and recommendations for building renovations/remediation. Budget Code(s): 61370035-870000-10069 Vendor <br /># 65016 (N/A if new vendor) Vendor is a BOCC consultant? Yes No Contract Type: (Check one) New Renewal <br />Amendment Effective Date 11/15/2019 Approved by Board Yes No Agenda Date: 11/7/19 <br /> <br />This agreement is approved as to technical form and content and I as Department Director affirmatively state work on this project has <br />not been initiated prior to execution of the agreement: <br /> <br /> <br />Department Director’s Signature ________________________________________ Date: ________ <br />Agreements for emergency services or repair are not subject to the above affirmation. If services related to this agreement have <br />already begun or been completed please briefly describe the nature of the emergency condition that was addressed: N/A <br /> <br />Information Technologies <br /> <br />(Applicable only to hardware/software purchases or related services) This agreement has been reviewed and is approved as to <br />information technology content and specifications: <br /> <br />Office of the Chief Information Officer___________________________________ Date: ________ <br /> <br />Risk Management <br /> <br />This agreement is approved for sufficiency of insurance standards, specifications, and requirements: <br /> <br />Office of the Risk Management Officer ___________________________________ Date: _________ <br /> <br />Financial Services <br /> <br />This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act: <br /> <br />Office of the Chief Financial Officer ____________________________________ Date: _________ <br /> <br />Legal Services <br /> <br />This agreement is approved as to legal form and sufficiency: <br /> <br />Office of the County Attorney __________________________________________Date: ________ <br /> <br /> <br />Clerk to the Board <br /> <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 /> <br />Office of the Clerk to the Board __________________________________________Date:_________ <br /> <br />DocuSign Envelope ID: 7854B471-4775-4981-BA75-1DF70A8C7286 <br /> <br /> <br /> <br />