Enter Basic Contract Information
Administrative Information
Basic Contract Details
Vendor Name |
MCCi, LLC
|
Vendor Number (3____ for AP and 00___ for AR) |
327684
|
Vendor Contact Name |
Candace Young
|
Vendor Contact Email |
[email protected]
|
Contract / Amendment Title |
Amendment #2
|
Contract / Amendment Amount |
$3,000.00
|
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? |
9027
|
Supplemental Insurance (for Risk team only) |
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Upload Contract Documents
Upload Documents
Upload Contract or Amendment Authorization Form |
MCCi+Amendment+-+12.30.20.pdf
|
Upload Agreement or Amendment |
MCCi+Amendment+2-revised_Signed_-8.25.20.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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Add any notes you may have for Finance and Risk Review teams. |
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Add name of RFP / RFQ / RFB, if issued |
n/a
|
Supplemental Risk Information
General Liability Details
Policy Effective Date |
12/17/19
|
Policy Expiration Date |
12/17/20
|
Policy Amount |
$1,000,000.00
|
Endorsements |
PNC, AI, WOS
|
Automobile Policy Details
Effective Date |
12/17/19
|
Expiration Date |
12/17/20
|
Policy Amount |
$1,000,000.00
|
Workers Comp Policy Details
Effective Date |
12/17/19
|
Expiration Date |
12/17/20
|
Policy Amount |
$1,000,000.00
|
Endorsements |
WOS
|
Professional Liability Policy Details
Effective Date |
12/17/19
|
Expiration Date |
12/17/20
|
Policy Amount |
$3,000,000.00
|
Other Policy Details
Other Policy Name 1 |
Cyber Liability
|
Effective Date 1 |
12/17/19
|
Expiration Date 1 |
12/17/20
|
Policy Amount 1 |
$3,000,000.00
|