Contract Review Process
May 31, 2022
submission
#1566
Enter Basic Contract Information
Administrative Information
| Contract Manager Name (City Staff) | Jonathan Holub |
| Contract Manager Email ([email protected]) | [email protected] |
| Administrator completing this workflow, if different (City staff) | Roger Vinalon Jr. |
| Administrator email ([email protected]) | [email protected] |
| Department | 05 - HSRS |
| Division | 62 - Rent Stabilization & Housing |
Basic Contract Details
| Vendor Name | DG Mediation, Inc. |
| Vendor Number (3____ for AP and 00___ for AR) | 329307 |
| Vendor Contact Name | Dina Glouberman |
| Vendor Contact Email | [email protected] |
| Contract / Amendment Title | Amendment 1 |
| Contract / Amendment Amount | $150,000.00 |
| 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? | 10118 |
| Supplemental Insurance (for Risk team only) | --- |
Upload Contract Documents
Upload Documents
| Upload Contract or Amendment Authorization Form | DG Mediation - Contract 10118 Amendment 1 Authorization.pdf |
| Upload Agreement or Amendment | DG Mediation - Contract 10118 Amendment 1.pdf |
| Upload Docusign "Certificate(s) of Completion" | DG Mediation - Contract 10118 Amendment 1 - DocuSign summary.pdf |
| Upload Insurance Documents (COI, Endorsements, WOS, etc.) | DG Mediation insurance 2.22.22.pdf, DG Mediation auto insurance 4.6.22.pdf, DG Mediation COI 3.21.22.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") | --- |
| Add any notes you may have for Finance and Risk Review teams. | --- |
Supplemental Risk Information
Upload Additional Insurance Files Here
| Additional Insurance File(s) | Insurance Submission for DG.pdf |
General Liability Details
| Waived | WAIVED |
Automobile Policy Details
| Effective Date | 04.06.2022 |
| Expiration Date | 1036.2022 |
| Policy Amount | $1,000,000.00 |
Workers Comp Policy Details
| Endorsements | Exempt |
| Waived | NOT REQUIRED |
Professional Liability Policy Details
| Effective Date | 03.22.22 |
| Expiration Date | 03.22.23 |
| Policy Amount | $1,000,000.00 |