Enter Basic Contract Information
Administrative Information
Basic Contract Details
Vendor Name |
NATIONAL GLASS LLC
|
Vendor Number (3____ for AP and 00___ for AR) |
329151
|
Vendor Contact Name |
Leslie Montoya
|
Vendor Contact Email |
[email protected]
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Contract / Amendment Title |
ON-CALL GLASS & GLAZING REPAIRS AMENDMENT NO. 1
|
Contract / Amendment Amount |
$25,000.00
|
Is this a new agreement or an amendment to an existing agreement? |
Amendment
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If this is if a Contract Amendment, what is the Contract Number? |
010043
|
Supplemental Insurance (for Risk team only) |
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Upload Contract Documents
Upload Documents
Upload Contract or Amendment Authorization Form |
Amendment_No1Coversheet.docx.pdf
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Upload Agreement or Amendment |
Amendment_No1.docx.pdf
|
Upload Docusign "Certificate(s) of Completion" |
Summary.pdf
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Upload Insurance Documents (COI, Endorsements, WOS, etc.) |
Insurance.pdf
|
Describe changes to Insurance Requirements, if any (if no insurance is required, type "None required") |
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Describe changes to Contract Template, if any (If none, type "None required") |
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Supplemental Risk Information
General Liability Details
Policy Effective Date |
01/01/2022
|
Policy Expiration Date |
01/01/2023
|
Policy Amount |
$1,000,000.00
|
Endorsements |
PNC, AI, WOS
|
Automobile Policy Details
Effective Date |
12/29/2021
|
Expiration Date |
12/9/2022
|
Policy Amount |
$1,000,000.00
|
Workers Comp Policy Details
Effective Date |
03/31/2021
|
Expiration Date |
03/31/2022
|
Policy Amount |
$1,000,000.00
|
Endorsements |
WOS
|
Other Policy Details
Other Policy Name 1 |
ExcessLiability
|
Effective Date 1 |
01/01/2022
|
Expiration Date 1 |
10/01/2023
|
Policy Amount 1 |
$2,000,000.00
|