Contracts

Contract Review Process

Feb 23, 2022
submission #1382
Enter Basic Contract Information

Administrative Information

Contract Manager Name (City Staff) Kristin Cook
Contract Manager Email ([email protected]) [email protected]
Administrator completing this workflow, if different (City staff) Jessica Anukam
Administrator email ([email protected]) [email protected]
Department 01 - CMD
Division 18 - Public Safety Administration

Basic Contract Details

Vendor Name The Maple Counseling Center
Vendor Number (3____ for AP and 00___ for AR) 314290
Vendor Contact Name Varina Bleil
Vendor Contact Email [email protected]
Contract / Amendment Title [email protected]
Contract / Amendment Amount $8,805.24
Is this a new agreement or an amendment to an existing agreement? Amendment
If this is if a Contract Amendment, what is the Contract Number? 009045
Supplemental Insurance (for Risk team only) ---
Upload Contract Documents

Upload Documents

Upload Contract or Amendment Authorization Form Authorization Form_Maple Counseling (Signed).pdf
Upload Agreement or Amendment Amendment_No3_Maple_Counseling_Center_ (Signed).pdf
Upload Docusign "Certificate(s) of Completion" Maple Authorization Summary.pdf, Maple Amendment Summary.pdf
Describe changes to Insurance Requirements, if any (if no insurance is required, type "None required") ---
Describe changes to Contract Template, if any (If none, type "None required") ---
Upload other supporting documents here, if necessary (e.g. staff reports, etc.) Staff Report - Consent Calendar - Maple Counseling Center.docx
Supplemental Risk Information

General Liability Details

Policy Effective Date 09/30/2021
Policy Expiration Date 09/30/2022
Policy Amount $1,000,000.00
Endorsements PNC, AI, WOS

Automobile Policy Details

Effective Date 09/30/2021
Expiration Date 09/30/2022
Policy Amount $1,000,000.00

Workers Comp Policy Details

Effective Date 03/14/2021
Expiration Date 03/14/2022
Policy Amount $1,000,000.00
Endorsements WOS

Professional Liability Policy Details

Effective Date 09/30/2021
Expiration Date 09/30/2022
Policy Amount $3,000,000.00