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DocuSign Envelope ID:CA518426-7674-44D9-B125-E4C45FD169AE <br /> ECS SOUTHEAST, LLP <br /> PROPOSAL ACCEPTANCE FORM <br /> ECS SOUTHEAST, LLP <br /> (Please Print or Type) <br /> Project Name: Orange County Court Street Annex Second Floor—Asbestos Services <br /> Location: 109 Court Street, Hillsborough, North Carolina <br /> Please check: _Task 1—Asbestos Plans and Specs; _Task 2 -Air Monitoring Services; <br /> Task 3—Designer's Final Review/Report <br /> Please complete and return this Proposal Acceptance Form to ECS. By signing and returning this form,you <br /> are providing us with authorization to proceed, providing us permission to enter the site,and making this <br /> proposal the agreement between us.Your signature also indicates that you have read this document and <br /> the general conditions of service in its entirety and agree to pay for these services. <br /> CLIENT AND BILLING INFORMATION <br /> Name of Client: <br /> Contact Person: <br /> Telephone No. <br /> E-mail: <br /> Responsible for Payment Approval of Invoice(if different) <br /> Contact Name: <br /> Company Name: <br /> Address <br /> Address <br /> City, State, Zip <br /> Telephone No.: <br /> Fax No: <br /> E-mail Address: <br /> Reports are normally e-mailed directly to client. If you require copies to others, please provide their <br /> names, e-mail addresses, and fax numbers below. <br /> Name e-mail Address Phone Number Fax Number <br /> Special Instructions: <br /> Client Signature: X Date: <br /> Please return signed authorization to Amberly Merritt at amerritt@ecslimited.com. <br /> a <br /> ECS Proposal No.49:22050-P <br /> Page 16 _ <br /> 0 <br />