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Oct 07, 2021
submission #1157
Enter Basic Contract Information

Administrative Information

Contract Manager Name (City Staff) Natalie Mignon
Contract Manager Email ([email protected]) [email protected]
Department 06 - FRS
Division 51 - Recreation Services

Basic Contract Details

Vendor Name Yorba Linda Feed Store Inc.
Vendor Number (3____ for AP and 00___ for AR) 328489
Vendor Contact Name Gary Gallegos
Vendor Contact Email [email protected]
Contract / Amendment Title Youth Halloween Hay and Equipment Rentals
Contract / Amendment Amount $1,132.46
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?
Supplemental Insurance (for Risk team only) ---
Upload Contract Documents

Upload Documents

Upload Contract or Amendment Authorization Form Yorba Linda Feed Contract Authorization YHC 2021 SIGNED DATE (1).pdf
Upload Agreement or Amendment Please_DocuSign_Agreement_Yorba_Linda_Feed_S (2).pdf
Upload Docusign "Certificate(s) of Completion" Please_DocuSign_Agreement_Yorba_Linda_Feed_S (2).pdf
Upload Insurance Documents (COI, Endorsements, WOS, etc.) YORBA LINDA FEED STORE INC. INSURANCE PACK YHC 2021.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") ---
Supplemental Risk Information

General Liability Details

Policy Effective Date 05/13/2021
Policy Expiration Date 05/13/2022
Policy Amount $1,000,000.00
Endorsements PNC, AI, WOS

Automobile Policy Details

Effective Date 05/13/2021
Expiration Date 05/13/2022
Policy Amount $1,000,000.00

Workers Comp Policy Details

Effective Date 05/13/2021
Expiration Date 5/13/2022
Policy Amount $1,000,000.00
Endorsements WOS