Enter Basic Contract Information
Administrative Information
| Contract Manager Name (City Staff) |
Jenny Ivanova
|
| Contract Manager Email ([email protected]) |
[email protected]
|
| Administrator completing this workflow, if different (City staff) |
|
| Administrator email ([email protected]) |
|
| Department |
01 - CMD
|
| Division |
15 - Community & Legislative Affairs
|
Basic Contract Details
| Vendor Name |
[email protected]
|
| Vendor Number (3____ for AP and 00___ for AR) |
328291
|
| Vendor Contact Name |
Jackie Steele
|
| Vendor Contact Email |
[email protected]
|
| Contract / Amendment Title |
Honorarium: SPECIAL CONTRACTED SERVICES
|
| Contract / Amendment Amount |
$200.00
|
| Is this a new agreement or an amendment to an existing agreement? |
New Agreement
|
| If this is if a Contract Amendment, what is the Contract Number? |
no
|
| Supplemental Insurance (for Risk team only) |
---
|
Upload Contract Documents
Upload Documents
| Upload Contract or Amendment Authorization Form |
Authorization_Form_Fillable_-_Patricia_Betzner-signed.pdf
|
| Upload Agreement or Amendment |
Honorarium_-_Jackie_Steele - signed.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. |
---
|
| Add name of RFP / RFQ / RFB, if issued |
no
|
| - or add weblink to RFP / RFQ / RFB, if issued |
no
|
Supplemental Risk Information
General Liability Details
| Waived |
Honorarium - no insurance required.
|
Automobile Policy Details
| Waived |
Honorarium - no insurance required.
|
Workers Comp Policy Details
| Waived |
Honorarium - no insurance required.
|
