HomeMy WebLinkAboutR 2019-010 AMS - ESG surface and air sampling testing for Link building DocuSign Envelope ID:COFFFEC3-61D5-446A-B969-A61327D203D9
ORANGE COUNTY—DEPARTMENT USE ONLY
Party/Vendor Name: Environmental Solutions Group, LLC Party/Vendor Contact Person: Dan Whittaker
(dwhittakerAjzo-esR com) Contact Phone: 336.392.8526 Party/Vendor Address: 1000 N. Elm Street City Greensboro
State:NC Zip: 27401 Department: AMS Amount:NTE: $2,000.00 Purpose: Provide surface and air quality sampling
at the John Link Government Services Building Budget Code(s): 10240320-630000 Vendor # 65016 (N/A if new
vendor) Vendor is a BOCC consultant? Yes ❑ No® Contract Type: (Check one) New ® Renewal ❑
Amendment ❑ Effective Date 1/4/19 Approved by Board Yes❑No® Agenda Date:
This agreement is approved as to technical form and content and I as Department Director affirmatively state work on
this project has not been initiated prior to execution of the agreement:
� P/anx� 1/3/2019
Department Director's Signature[IX — Date:
Agreements for emergency services or repair are not subject to the above affirmation. If services related to this
agreement have already begun or been completed please briefly describe the nature of the emergency condition that was
addressed: N/A
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:
Office of the Risk Management Office KSu bn1t f° Date:1/3/2019
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control Act:
PL
Office of the Chief Financial Office �N "` Date: 1/4/zo19
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney k�rov s Date:1/8/2019
Clerk to the Board
Received for record retention:
All Docusign contracts must be copied to Sherri Ingersoll upon completion: singersoll@orangecountync.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 12/18 4