HomeMy WebLinkAboutContract 45749-R3 q lik" 0 CSC No. `t J J�I_ Q3
CITY OF FORT WORTH
�F%9 k��� CONTRACT RENEWAL NOTICE
VA
July 27,2013
IPS Advisors,a division of HUB International
10000 N. Central Expressway, Ste 1100
Dallas,TX 75231
Attn:President
Re: NOTICE OF CONTRACT RENEWAL
ACA Compliance Reporting
Contract No.CSC No.45749(the"Contract")
Renewal Term No.3:June 30,2018 to June 30 2019
The above referenced Contract will expire on June 30,2018. 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.45749 for an additional one year period, which
will begin immediately upon the expiration of the current term and will end on June 30, 2019. All other terms and conditions of CSC
No. 45749 remain unchanged. Please return this signed acknowledgement letter, along with a copy of your current insurance
certlficate,to the address set forth below,acknowledging receipt of the Notice of Contract Renewal.
Please log onto BuySpeed Online at httpa fort\t nrllrtex,ts.gov(p�trcila5.n;to insure that your company infomiation is correct and tip-
to-date.
If you have any questions concerning this Contract Renewal Notice,please contact me at the telephone number listed below.
Sincerely yours,
Joaiute into"
Benefits Manager
Human Resources Department
817-392-6275
I hereby acknowledge receipt of the Contract Renewal Notice for CSC No.45749 for a one year period ending on June 30,2019.
By: I'a;c1 J3u S t k Gl Te4�- Ser"'(e ltici"°Scl- Date: 8/ ?z &t$
Printed Nante and Title
Si;na ttre
CITY T WOR ATT T:
Susan Tani ,f Assistant City Managerry Ka s Cit Secreta
Date: __ I a� `� M&C No. _ net required
RECOMMENDED BY:
Maine and Tide APPROVED AS M F0__RrMn_ UEG A_111M
OFFICIAL RECORD
M&C:— 'i I AITY ATTORN h
1295:
R 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