Enter Basic Contract Information
Administrative Information
Basic Contract Details
| Vendor Name |
Stommel Inc. DBA / LEHR
|
| Vendor Number (3____ for AP and 00___ for AR) |
328942
|
| Vendor Contact Name |
Nick Brophy
|
| Vendor Contact Email |
[email protected]
|
| Contract / Amendment Title |
Code Complance Vehicle Computers - Amendment 3
|
| Contract / Amendment Amount |
$0.00
|
| 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? |
#009846
|
| Supplemental Insurance (for Risk team only) |
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Upload Contract Documents
Upload Documents
| Upload Contract or Amendment Authorization Form |
Stommel_Inc._Amendment Authorization Form.pdf
|
| Upload Agreement or Amendment |
Stommel_Inc._Amendment3 - Signed.pdf
|
| Upload Docusign "Certificate(s) of Completion" |
Authorization Form Certificate of Completion 1.pdf, Authorization Form Certificate of Completion.pdf, Amendment Certificate of Completion.pdf
|
| Upload Insurance Documents (COI, Endorsements, WOS, etc.) |
Lehr Blanket AI WOS.pdf, Lehr COI CWH.pdf, Lehr Insurance.pdf, Lehr WOS WC.pdf, Leht COWH AI.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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|
Supplemental Risk Information
General Liability Details
| Policy Effective Date |
05/01/20
|
| Policy Expiration Date |
05/01/21
|
| Policy Amount |
$1,000,000.00
|
| Endorsements |
PNC, AI, WOS
|
Automobile Policy Details
| Effective Date |
05/01/20
|
| Expiration Date |
05/01/21
|
| Policy Amount |
$1,000,000.00
|
Workers Comp Policy Details
| Effective Date |
05/01/20
|
| Expiration Date |
05/01/21
|
| Policy Amount |
$1,000,000.00
|
| Endorsements |
WOS
|
