Enter Basic Contract Information
Administrative Information
Basic Contract Details
Vendor Name |
AAA Flag and Banner Company
|
Vendor Number (3____ for AP and 00___ for AR) |
300003
|
Vendor Contact Name |
AAA Flag & Banner Mfg. Co.
|
Vendor Contact Email |
[email protected]
|
Contract / Amendment Title |
Contract Amendment #1 - OUT Zone Barricade Covers
|
Contract / Amendment Amount |
$25,000.00
|
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? |
9901
|
Supplemental Insurance (for Risk team only) |
---
|
Upload Contract Documents
Upload Documents
Upload Contract or Amendment Authorization Form |
Contract_Amendment_Cover_Sheet.pdf
|
Upload Agreement or Amendment |
Contract_Amendment_1_(11.16.20).docx.pdf
|
Upload Docusign "Certificate(s) of Completion" |
Summary.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. |
---
|
Upload other supporting documents here, if necessary (e.g. staff reports, etc.) |
|
Supplemental Risk Information
General Liability Details
Policy Effective Date |
05/15/20
|
Policy Expiration Date |
05/15/21
|
Policy Amount |
$1,000,000.00
|
Endorsements |
PNC, AI, WOS
|
Automobile Policy Details
Effective Date |
05/15/20
|
Expiration Date |
05/15/21
|
Policy Amount |
$1,000,000.00
|
Workers Comp Policy Details
Effective Date |
05/15/20
|
Expiration Date |
05/15/21
|
Policy Amount |
$1,000,000.00
|
Endorsements |
WOS
|
Other Policy Details
Other Policy Name 1 |
Excess Liability
|
Effective Date 1 |
05/15/20
|
Expiration Date 1 |
05/15/21
|
Policy Amount 1 |
$5,000,000.00
|