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<br /> <br />ECS Proposal 06:24601 <br />Page | 2 <br />ECS Southeast, LLC September 25, 2024 <br /> <br />PROPOSAL ACCEPTANCE FORM <br />ECS SOUTHEAST, LLC <br /> <br />Project Name: Orange County Efland EMS Station (Stone Depth) <br />Location: 3800 US 70 W, Efland, NC <br />Estimate: $5,000 <br /> <br />Please complete and return this Proposal Acceptance Form. By signing and returning this form, you are <br />authorizing ECS to proceed, providing ECS permission to enter the site, and making this proposal the <br />agreement between ECS and Orange County - Asset Mgmt. & Purchasing. Your signature also indicates <br />you have read this document and the Terms and Conditions of Service in their entirety and agree to pay <br />for services as above set forth. <br /> <br />CLIENT AND BILLING INFORMATION <br />Name of Client: <br /> <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 /> <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 /> <br />Name e-mail Address Phone Number Fax Number <br /> <br /> <br /> <br />Special Instructions: __________________________________________________________________ <br />____________________________________________________________________________________ <br /> <br />Client Signature:  ______________________________________ Date: _______________________ <br /> <br />Please return signed authorization to Suman Uprety at SUprety@ecslimited.com or fax (919) 861-9911. <br />Docusign Envelope ID: 6A9D5D34-5CDF-4B61-99A9-F61CBCEDBF5E