Enter Basic Contract Information
Administrative Information
| Contract Manager Name (City Staff) |
Christine Safriet
|
| Contract Manager Email ([email protected]) |
[email protected]
|
| Department |
01 - CMD
|
| Division |
11 - Assistant City Manager
|
Basic Contract Details
| Vendor Name |
Fairbank, Maslin, Maullin, Metz & Associates (FM3)
|
| Vendor Number (3____ for AP and 00___ for AR) |
325226
|
| Vendor Contact Name |
Richard Bernard
|
| Vendor Contact Email |
[email protected]
|
| Contract / Amendment Title |
Community Survey
|
| Contract / Amendment Amount |
$50,000.00
|
| 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 |
FM3 - Authorization.pdf
|
| Upload Agreement or Amendment |
FM3-Weho_Community_Survey_Oct2021_Contract.pdf
|
| Upload Docusign "Certificate(s) of Completion" |
Summary.pdf
|
| Upload Insurance Documents (COI, Endorsements, WOS, etc.) |
FM3 - City of West Hollywood - Insurance 2021-22.pdf, WeHo Insurance Requirements 1.2016 Basic - Checklist.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 name of RFP / RFQ / RFB, if issued |
None. Vendor selected for professional qualifications, expertise, and schedule.
|
Supplemental Risk Information
General Liability Details
| Policy Effective Date |
01/13/2021
|
| Policy Expiration Date |
01/13/2022
|
| Policy Amount |
$1,000,000.00
|
| Endorsements |
PNC, AI, WOS
|
Automobile Policy Details
| Effective Date |
01/13/2021
|
| Expiration Date |
01/13/2022
|
| Policy Amount |
$1,000,000.00
|
Workers Comp Policy Details
| Effective Date |
01/13/2021
|
| Expiration Date |
01/13/2022
|
| Policy Amount |
$1,000,000.00
|
| Endorsements |
WOS
|
Professional Liability Policy Details
| Effective Date |
01/13/2021
|
| Expiration Date |
01/13/2022
|
| Policy Amount |
$2,000,000.00
|
