HomeMy WebLinkAboutR 2016-287-E Planning - Pilot Environmental, Inc. for Phase 1 Environmental Site Assessment DocuSign Envelope ID: DE50C3DC-2C59-4045-8605-848OD42217C5
ORANGE COUNTY—DEPARTMENT USE ONLY
Department
Party/Vendor Name: Pilot Environmental, Inc. Party/Vendor Contact Person: Michael Brame Contact Phone: (336)
708-4620 Party/Vendor Address: P.O. Box 128 City : Kernersville State: CA Zip: 27285 Department: Planning &
Inspections Amount: $1,600,00 Purpose: Phase 1 Environmental Site Assessment Budget Code(s): 61370035-870000-
30044 Vendor#62512 (N/A if new vendor) Vendor is a BOCC consultant? Yes ❑ No[] Contract Type: (Check
one) New ® Renewal ❑ Amendment ❑ Effective Date 05/23/2016 Approved by Board Yes❑ No[]
Agenda Date: N.A.
This agreement is approved as to technical form and content:
D Sig d by:
Department Director's Signature (Yai� 130/u �d-� Date: 5/25/2016
Information Technologies
(Applicable only to hardware/software purchases or related services)This agreement has been reviewed and is
approved as to information technology content and specifications:
Office of the Chief Information Officer Date:
Risk Management
This agreement is approved for sufficiency of insurance standards, specifications, and requirements:
D Sig d by:
Office of the Risk Management Officer2"', Cb�b Date: 5/25/2016
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
D Sig d by:
Office of the Chief Financial Office Date: 6/3/2016
Legal Services
This agreement is approved as to legal form and sufficiency:
DocuSigned by:
Office of the County Attorne 16LVI I°o uw Date: 6/6/2016
EAA3D33ED8A8465...
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Donna Lloyd upon completion @ Dolloyd @orangecount,nc.gov
The following signature block is for hard copies only and is not required for Docusign contracts:
Office of the Clerk to the Board Date:
Revised 1/16 4