Enter Basic Contract Information
Administrative Information
Basic Contract Details
| Vendor Name |
Housing Works
|
| Vendor Number (3____ for AP and 00___ for AR) |
322174
|
| Vendor Contact Name |
Celena Alvarez
|
| Vendor Contact Email |
[email protected]
|
| Contract / Amendment Title |
Amendment No. 3
|
| Contract / Amendment Amount |
$5,000.00
|
| 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? |
9577
|
| Supplemental Insurance (for Risk team only) |
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|
Upload Contract Documents
Upload Documents
| Upload Contract or Amendment Authorization Form |
Housing_Works_Amendment_3- Authorization.pdf
|
| Upload Agreement or Amendment |
Amend_No._3_ Signed.pdf
|
| Upload Docusign "Certificate(s) of Completion" |
Summary.pdf, Amend No. 3 Summary.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 |
None
|
Supplemental Risk Information
General Liability Details
| Policy Effective Date |
12/01/20
|
| Policy Expiration Date |
12/01/21
|
| Policy Amount |
$1,000,000.00
|
| Endorsements |
PNC, AI, WOS
|
Automobile Policy Details
| Effective Date |
12/01/20
|
| Expiration Date |
12/01/21
|
| Policy Amount |
$1,000,000.00
|
Workers Comp Policy Details
| Effective Date |
12/01/20
|
| Expiration Date |
12/01/21
|
| Policy Amount |
$1,000,000.00
|
| Waived |
Missing WC WOS
|
Professional Liability Policy Details
| Effective Date |
12/01/20
|
| Expiration Date |
12/01/2
|
| Policy Amount |
$2,000,000.00
|
Other Policy Details
| Other Policy Name 1 |
Abuse and Molestation
|
| Effective Date 1 |
12/01/20
|
| Expiration Date 1 |
12/01/21
|
| Policy Amount 1 |
$2,000,000.00
|
