HomeMy WebLinkAboutContract for Safety Department (BPW Approved 2/14/24) City of Jeffersonville
Government Contract Coversheet
Please note: All information MUST be completely filled out and submitted to Clerk's Office
within 48 hrs of execution.
Date Submitted to Clerk: c1A//c)r
Department: Sct
4(
Vendor Name: Veauf Solt►libvts
Sign Date:, 21/11!2.LI
Ending Date: I Jo3/2 j
Amount of Original Contract: `i4a )*, °s
Is this an amendment or change order
to original contract? Yes or No
Amended Contract Amount: ft 201 •9l0
Purpose: A r
tratli wit4 a iplotiet yt
1.ncidfMr iAVCSi9at o4 1 'US$ '644':1 (v051-044
For Clerk's Office to fill out
Date uploaded to Gateway:
DocuSign Envelope ID: BB75990D-9295-423E-A44C-D9A9B97086F9
{ Quote ID
JO Q-310956
# ®11 C or l utl ns Valid until
Monday,January 16,2024
Contact Name
Casale Waldrop
Schedule A— Revision
This Contract Revision Form replaces and supersedes Schedule A to the Client Agreement signed on 10/25/2021 between the
Vector Solutions entity and the Client named below as of the Effective Date(Contract Revision Order No, 1 Effective Date).
Date:Wednesday,January 3,2024
Client Information
Client Name: City of Jeff
Address:
500 Quartermaster Ct.
Jeffersonville, IN 47130
Primary Contact Name: Primary Contact Phone:
Brian Smith (502)795-4162
Agreement Term
Effective Date: I initial Term:
, 01/03/2024 36 months
Invoicing Contact information (Please fill in missing information)
_
Billing Contact Name: Brian Smith
�
Bluing Address: Billing Phone:
500 Quartermaster Ct. (812)280-3805
Jeffersonville, Indiana 47130
Billing Email: ____ PO#: Billing Frequency: j Payment ____
bsmith@cityofjeff.net Annual Terms:
Net 30
Fees
EHSPRO Vector EHS- EHS Professional Software-Key
Professlocal Modules and Features 404 $11.88 $201.96
ISHome Home Home Module 1 $0.00 $0.00
Hazards Hazards $0.00 $0,00
CorreotiveActlons Corrective Actions $0.00 $0.00
DocuSign Envelope ID: BB75990D-9295-423E-A44C-D9A9B97086F9
(SDashboardDas Dashboard Dashboard Module 1
• hboard $0.00 $0 00
ISPWF Public Web Form Public Web Forms 1 $0.00 $0.00
ISIncidents Incidents incidents Module 1 $0.00 $0.00
ISClaimsClaims Claims Claims Module 1 $0.00 $0.00
Employeelnterfac
e Employee Interface 404 $0.00 $0.00
SingleSignOn Single Sign On/
User Interface 404 $0.00 $0.00
Employeelnterfac Employee Interface
eSetupFea Set up Fee 404 $0.00 $0.00
Sing!eSignOnSet Single Sign On Set
404 $0.00 $0.00
upFee up Fee i
Grand Total: $201.96
Please note that this is not an invoice.An invoice will be sent within fourteen(14)business days.
The Parties have executed this Agreement by their authorized representatives as of the last date set forth below.
RedVector.com LLC d/b/a Vector Solutions City of Jeff
4890 W.Kennedy Blvd., Suite 300 500 Quartermaster Ct.
Tampa, FL 33609 Jeffersonville, IN47$30/
—DocuSigned by: f
a : 3GSSt, RaV'wicic ,-l
y `—05AE4B7EE5B7445... By: "1.,,,,,---- v 4' ,
Printed Name:Jesse Harwick Printed Name: +�L-► b t Ct
Title: Director of Sales Title. 1 ar
2/14/2024
Date: Date:
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DocuSign Envelope ID:BB75990D-9295-423E-A44C-D9A9B97086F9
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