Enter Basic Contract Information
Administrative Information
Basic Contract Details
Vendor Name |
SAFEGUARD INDUSTRIES
|
Vendor Number (3____ for AP and 00___ for AR) |
329992
|
Vendor Contact Name |
Mark Calderone
|
Vendor Contact Email |
[email protected]
|
Contract / Amendment Title |
FALL ARREST SYSTEM ANNUAL INSPECTION, TESTING & WARRANTY SERVICES
|
Contract / Amendment Amount |
$20,000.00
|
Is this a new agreement or an amendment to an existing agreement? |
New Agreement
|
Supplemental Insurance (for Risk team only) |
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Upload Contract Documents
Upload Documents
Upload Contract or Amendment Authorization Form |
ContractCoversheet.docm.pdf
|
Upload Agreement or Amendment |
Safeguard_Industries_Contract_2022.docx.pdf
|
Upload Docusign "Certificate(s) of Completion" |
Summary.pdf
|
Upload Insurance Documents (COI, Endorsements, WOS, etc.) |
Insurance Safeguard Submitted 08-23-22.pdf, Insurance Safeguard.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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Supplemental Risk Information
Upload Additional Insurance Files Here
General Liability Details
Policy Effective Date |
07/01/2022
|
Policy Expiration Date |
07/01/2023
|
Policy Amount |
$5,000,000.00
|
Endorsements |
PNC, AI, WOS
|
Automobile Policy Details
Effective Date |
07/01/2022
|
Expiration Date |
07/01/2023
|
Policy Amount |
$10,000.00
|
Workers Comp Policy Details
Effective Date |
04/1/2022
|
Expiration Date |
04/01/2023
|
Policy Amount |
$1,000,000.00
|
Endorsements |
WOS
|
Professional Liability Policy Details
Other Policy Details
Other Policy Name 1 |
Umbrella Coverage
|
Effective Date 1 |
07/01/2022
|
Expiration Date 1 |
07/01/2023
|
Policy Amount 1 |
$5,000,000.00
|