Enter Basic Contract Information
Administrative Information
Basic Contract Details
| Vendor Name |
Susan M. LaVaccare
|
| Vendor Number (3____ for AP and 00___ for AR) |
325293
|
| Vendor Contact Name |
Sue M. LaVaccare
|
| Vendor Contact Email |
[email protected]
|
| Contract / Amendment Title |
Amendment No. 1
|
| 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? |
9567
|
| Supplemental Insurance (for Risk team only) |
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Upload Contract Documents
Upload Documents
| Upload Contract or Amendment Authorization Form |
Contract Amendment Authorization Form Susan M. LaVaccare.pdf
|
| Upload Agreement or Amendment |
Amendment No. 1 Susan M. LaVaccare.pdf
|
| Upload Docusign "Certificate(s) of Completion" |
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
|
| - or add weblink to RFP / RFQ / RFB, if issued |
none
|
Supplemental Risk Information
General Liability Details
| Waived |
no insurance required
|
Automobile Policy Details
| Endorsements |
no insurance required
|
Workers Comp Policy Details
| Waived |
no insurance required
|
