HomeMy WebLinkAboutR 2018-823 AMS - Environmental Solutions Group air surface samplingRevised 10/17
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ORANGE COUNTY—DEPARTMENT USE ONLY
______________________________________________________________________________
Department
Party/Vendor Name: Environmental Solutions Group, LLC Party/Vendor Contact Person: Dan Whittaker,
(dwhittaker@go-esg.com) Contact Phone: 336-392-8526 Party/Vendor Address: 1000 N. Elm Street City
Greensboro State: NC Zip: 27402 Department: AMS Amount: NTE $15,000.00 Purpose: Provide air and surface
sampling at multiple Orange County facilities 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 12-13-18 Approved by Board Yes No Agenda Date:
This agreement is approved as to technical form and content:
Department Director’s Signature ________________________________________ Date: ________
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 Officer___________________________________ Date: _________
Financial Services
This instrument has been pre-audited in the manner required by the Local Government Budget and Fiscal Control
Act:
Office of the Chief Financial Officer ____________________________________ Date: _________
Legal Services
This agreement is approved as to legal form and sufficiency:
Office of the County Attorney __________________________________________Date: ________
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:_________
DocuSign Envelope ID: 5FFD25A8-C8E6-404B-8C2D-16ED694C4EDC