HomeMy WebLinkAboutContract 46248-R1 �1 �g10 rr r2��
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CSC No. 46248 1
CITY OF FORT WORTII
CONTRACT RENEWAL NOTICE
November 2,2017
Delta Dental
1130 Sanctuary Parkway
Suite 600
Alpharetta,GA 30009
Re: NOTICE OF CONTRACT RENEWAL
Group Dental Service Contract-Group numbers 17182&76983
Contract No.CSC No.46248(the"Contract")
Renewal Term No. 1:January 1,2018—December 31,2018
The above referenced Contract will expire on December 31,2017.Pursuant to the Contract,contract renewals are at the sole option of
the City.This letter is to inform you that the City is exercising its right to renew CSC No.46248 for an additional one year period,which
will begin immediately upon the expiration of the current term and will end on December 31,20I8.All other terms and conditions of
CSC No.46248 remain unchanged.Please return this signed acknowledgement letter,along with a copy of your current insurance
certificate,to the address set forth below,acknowledging receipt of the Notice of Contract.Renewal.
Please log onto BuySpeed Online at htip://fortworthtexas.aor•/purchasing to insure that your company information is correct and up-to-
date.
If you have any questions concerning this Contract Renewal Notice,please contact me at the telephone number listed below.
Sincerely yours,
Margaret Wise,Asst.Director of Human Resources
817-392-8058-Direct
817-392-2624-Fax
I hereby acknowledge receipt of the Contract Renewal Notice for CSC No.46248 for a one year period ending on December 31,2018.
By: 1 s 52 bd VRS lis' Date:
ted Name and Title
U11 FORT
Sig ure �
CITY OF ORT WORTH: A'fTES 0,,
Susan Alanis,Assistant City Manager Mary J.KaysqLyty Sry
Date: L �XR
ti 1"M�� M&C No. C-17182 `
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11viENDED BY: res
Name and Title /
OFFICIAL RECORD
CITY SECRETARY CI ATTO EY �u�n t3.4hu�j
FT-WORTH,TX
Contract Compliance Manager:
By signing I acknowledge that I am the person responsible
for the monitoring and administration of this contract, including
ensuring all performance and reporting requirements.
Name of Employee/Signature
Title
This form is N/A as No City Funds are associated with this Contract
Printed Name Signature