Enter Basic Contract Information
Administrative Information
Basic Contract Details
| Vendor Name |
Alena A. Eckhardt
|
| Vendor Number (3____ for AP and 00___ for AR) |
329147
|
| Vendor Contact Name |
Alena A. Eckhardt
|
| Vendor Contact Email |
[email protected]
|
| Contract / Amendment Title |
Agreement for Hearing Officer Services
|
| Contract / Amendment Amount |
$12,500.00
|
| Is this a new agreement or an amendment to an existing agreement? |
New Agreement
|
| Supplemental Insurance (for Risk team only) |
---
|
Upload Contract Documents
Upload Documents
| Upload Contract or Amendment Authorization Form |
EdenContractAuthorizationForm_Fillable-A._Eckhardt CS.pdf
|
| Upload Agreement or Amendment |
Hearing_Officer_Services_Agreement_-_A._Eckhardt_-_exp_6.30.21 CS - dated.pdf
|
| Upload Docusign "Certificate(s) of Completion" |
Summary - CS.pdf, Summary.pdf
|
| Upload Insurance Documents (COI, Endorsements, WOS, etc.) |
20201201_PC_auto.pdf
|
| Describe changes to Insurance Requirements, if any (if no insurance is required, type "None required") |
---
|
| Upload approval for insurance changes, if any (e.g., email from Risk) |
---
|
| Describe changes to Contract Template, if any (If none, type "None required") |
---
|
| Upload approval for contract template changes (e.g., email from Finance or City Attorney) |
---
|
Supplemental Risk Information
General Liability Details
| Waived |
GL waived per City Attorney
|
Automobile Policy Details
| Effective Date |
01/04/21
|
| Expiration Date |
07/04/21
|
Workers Comp Policy Details
