Enter Basic Contract Information
Administrative Information
Basic Contract Details
| Vendor Name |
11:11 A Creative Collective
|
| Vendor Number (3____ for AP and 00___ for AR) |
328386
|
| Vendor Contact Name |
Erin Stone
|
| Vendor Contact Email |
[email protected]
|
| Contract / Amendment Title |
Technical Assistance Consultant
|
| Contract / Amendment Amount |
$2,000.00
|
| Is this a new agreement or an amendment to an existing agreement? |
New Agreement
|
| Supplemental Insurance (for Risk team only) |
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|
Upload Contract Documents
Upload Documents
| Upload Contract or Amendment Authorization Form |
1111 Contract Auth.pdf
|
| Upload Agreement or Amendment |
1111 Contract 2021.pdf
|
| Upload Docusign "Certificate(s) of Completion" |
1111 cert.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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|
Supplemental Risk Information
General Liability Details
| Policy Effective Date |
|
| Policy Expiration Date |
|
| Policy Amount |
|
| Endorsements |
|
| Waived |
Virtual Waiver Submitted
|
Automobile Policy Details
| Effective Date |
10/1/20
|
| Expiration Date |
10/1/21
|
| Policy Amount |
$1,000,000.00
|
Workers Comp Policy Details
| Effective Date |
|
| Expiration Date |
|
| Policy Amount |
|
| Waived |
Virtual Waiver Submitted
|
