Enter Basic Contract Information
Administrative Information
Basic Contract Details
Vendor Name |
Maggie Thomas
|
Vendor Number (3____ for AP and 00___ for AR) |
327120
|
Vendor Contact Name |
Maggie Thomas
|
Vendor Contact Email |
[email protected]
|
Contract / Amendment Title |
Amendment No. 3
|
Contract / Amendment Amount |
$0.00
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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? |
008713
|
Supplemental Insurance (for Risk team only) |
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Upload Contract Documents
Upload Documents
Upload Contract or Amendment Authorization Form |
Contract_Authorization_Form_-_Maggie_Thomas.docx.pdf
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Upload Agreement or Amendment |
Amendment_Basic_No_3_-_Maggie_Thomas.docx.pdf
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Upload Docusign "Certificate(s) of Completion" |
Summary.pdf
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Describe changes to Insurance Requirements, if any (if no insurance is required, type "None required") |
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Upload approval for insurance changes, if any (e.g., email from Risk) |
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Describe changes to Contract Template, if any (If none, type "None required") |
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Add any notes you may have for Finance and Risk Review teams. |
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Add name of RFP / RFQ / RFB, if issued |
none
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Supplemental Risk Information
General Liability Details
Automobile Policy Details
Workers Comp Policy Details