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AMENDMENT NO.TWO TO CITY SECRETARY
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TO
4 CITY SECRETARY CONTRACT NO.47894 NAd
RECEIVED
a JAN
3, 2018 STATEMENT OF WORK#20180108
� CITY OF FORT�ORTH
CIN SF r gami Risk LLC ("Origami")and the City of Fort Worth("Client")previously entered into City Secretary
Contract No.47894, entitled"Master Services Agreement—Software Licenses and Services Agreement,"dated June 20,
2016,as amended(the"Agreement").This Amendment No.Two to the Agreement("Amendment")adds an additional
Statement of Work("SOW"),attached as Exhibit A,which describes supplemental services to be performed and licenses
to be provided by Origami for Client under the Agreement.Both the Amendment and SOW are subject to all the terms
and conditions of the Agreement.
TERM
The term of this SOW shall begin on 1/8/2018 and shall be coterminous with the term of the Agreement.
PROJECT SCOPE
Client agrees to purchase the following additional licenses:
Light User: 1 One. These licenses have access to the dashboard,reports pre-configured for them,and read-only access
to other areas of the system. Light Users do not have access to the Administration features, and do not have access to
those features listed within the Extended Functionality Licenses section.
Full User: 2 Two. These licenses have access to all the capabilities and features of Origami Risk,except those features
utilized for adjusting claims such as check writing,setting reserves and calculating indemnity benefits,and except for
those features listed within the Extended Functionality Licenses section.
Claims Adjusting User: 1 One. These licenses have access to all the features and capabilities of Origami Risk,except
those features listed within the Extended Functionality Licenses section.
PRICING AND INVOICE SCHEDULE
The price for the licenses listed above in this SOW is$2,575.00 for the current contract year. Thereafter,the billable
amount for each year of the Agreement will increase by$5,150.00. Such payments will be due as follows:
Year 2(1/8/2018):
1 Light User License-$200.00(prorated rate of$200.00)
2 Full User Licenses-$1,250.00(prorated rate of$625.00 for each user)
1 Claims Adjusting User License-$1,125.00(prorated rate of$1,125.00)
Year 3 (6/20/2018):
1 Light User License-$400.00
2 Full User Licenses -$2,500.00($1,250.00 for each user)
1 Claims Adjusting User License-$2,250.00
All fees are subject to state sales tax where applicable.
OFFICIAL RECORD
CITY SECRETARY
FT.WORTH,TX
STATEMENT OF WORK APPROVAL
The undersigned agree to this Statement of Work.
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ORIGAMI RISK LLC Ol�9an�� City of Forth Worth
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By: 07� By:
Name: _Robert G. Petrie III Nai,.--) `I SQ V1 `
(Print Name) (Print Name)
Title: President and CEO Title: 75}. �( k/
Date: I /Z�(� Date: p ' Prom
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APPROVED AS TO FORM AND LEGALITY
ITY ATMANtY
Mary J. K 'ty i9ecretwy
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OFFICIAL RECORD
CITY SECRETARY
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.
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Name of Employee/Signature
Title (/ j
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❑ This form is N/A as No City Funds are associated with this Contract
Printed Name Signature