HomeMy WebLinkAboutVerizon (Cellular Service for Planning & Zoning) 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: 1 — D-O �`{
Department: (i-3\ G�n� X
Vendor Name: V C C\ r,
Sign Date: \ t.QaH
Ending Date: \r 3\r ao rD5
Amount of Original Contract: (p00,m
Is this an amendment or change order
to original contract? Yes or No
Amended Contract Amount:
Purpose:
For Clerk's Office to fill out
Date uploaded to Gateway:
verizon
State of Indiana BPA # 71748 with
GSA-Multiple Award Schedule Purchase Order (47QTCA20D00B5)
Date: January 29,2024
Vendor: Verizon Wireless
Vendor Address: 10170 Junction Drive
Annapolis Junction,MD 20701
Vendor Email: FederalAcctImplementations@VerizonWireless.com
Phone: 1.800.561.6227 Option 3
FAX: 1.866.227.4978
Authorized By: I represent that the Agency named below is a Governmental Body(Agency)authorized to purchase
under this State of Indiana Agreement(government,non-profit or education).I further represent
that I am authorized to commit the Agency named below to purchase under the GSA Multiple
Award Schedule and that the use of all products/services purchased is for authorized government
use.This commitment only authorizes me to enter into this transaction on behalf of the Agency
named below.It creates no commitment on the part of this agency to purchase a minimum or
maximum quantity of goods or services.ANY RESELLING OF PRODUCTS/SERVICES PURCHASED
UNDER THIS ORDER ARE STRICTLY PROHIBITED,as the contract and governing regulations require
that all MAS purchases will be used for governmental purposes only and will not be resold for
personal use.
Agency Name:Jeffersonville Plan/Zone
Signature of Authorized Official:
Printed or typed name:Chad Reischl
Printed or typed title:Director
Contact Information: Email address:creischl@cityofjeff.net
Phone number:812-280-3855 FAX number:
Billing Information: 500 Quatermaster Court,Ste 200,Jeffersonville,In 47130
Payment Terms: Net 30
Description of Cellular service on the accounts listed below(or attached)totaling up to 10 units in accordance with
Goods/Services; the rate plans and terms and conditions now or in the future applicable to each of such lines
Pricing: pursuant to GSA Multiple Award Schedule 47QTCA20D00B5,
Rate Plan(s):Various
Equipment:Various
January 29,2024 for 12 months through 2025
Term: (month)(day)(yr.) (#) (year)
The quantities listed are estimates only and are based on past and future usage.You may
Funds Authorized: purchase less than the amounts shown,but no more.Purchases in excess of the amount shown
will need an updated order form.All services orders shall be on an"as needed"basis,subject to
the availability of funding and budgetary considerations.
Monthly Access Fees for service on up to 10 lines(Estimated) $500.00
Equipment charge(s)on up to 10 lines (Estimates) $1000.00
Total Access and Equipment Fees on up to 10 lines(Estimate) $7000.00
Plus applicable fees,taxes and charges
450 GSA Multiple Award Schedule Contract Number 47QTCA20D00B5,State of Indiana BPA#71748,all
terms and conditions are incorporated by reference.
Equipment None of the equipment listed are products listed on GSA Multiple Award Schedule Contract No.
(Open Market): 47QTCA20D00B5.All devic s a i or accessories are"Open Market"items.Various
Specify Phones,Delivery, c.: • .file ID# 52935 (all accounts and sub-accounts)
Miscellaneous: **Please notify PO at 0 •• s prior t unding document expiration date**
Customer Acceptance: Signature: I Date: d "D,L(
For Verizon Wireless internal use only: Approval: Date: