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Home My WebLink AboutContract 49869-R1 CITY SECRETARY CONTRACT NO. $to'+KA CITY OF FORT WORTH REQUEST TO EXERCISE RENEWAL OPTION City Secretary Contract No.49869 December 26,2018 Monnie Louise Reid 5320 Dusty Rd. Athens,TX 75752 Re: REQUEST TO EXERCISE RENEWAL OPTION CSC No.49869(the"Contract") Renewal Term December 16,2018 through May 3,2019 The above referenced Contract expired on December 15,2018. Pursuant to the Contract,renewals are at the mutual agreement of the parties. This letter is to inform you that the City requests renewal of CSC No.49869 for an additional five month period,which will begin immediately upon the expiration of the current term and will end on May 3,2019. All other terms and conditions of CSC 49869 remain unchanged. Please return your signed agreement letter,along with a copy of your current insurance certificate,to the address set forth below. If you have any questions concerning this Request for Contract Renewal,please contact me. Sincerely yours, Mailing Address: City of Fort Worth Kathy Agee-Dow IT Finance—Kathy Agee-Dow Senior Contract Compliance Specialist 200 Texas Street Kathryn.Agee-Dow(i>)fortworthtexas. ov Fort Worth,TX 76102 817-392-8461 I hereby acknowledge receipt of the Contract Renewal Notice for CSC No.49869 for a five month period ending on May 3,2019. ,( / p� By: f A Ile Lo�t15�. ��I ( 7tbPt+ Date: �,2-l.z� /,lot 0 Printed Name and Tit e 4 Signature % ,a U. '•2 C ORT WORTH: A TE 'k Sus anis,Assistant City Manager IMart J.Kayser,City Sec et Date: M&C(if required) N/A Approved Date: N/A_ ,/44 yllzb OFMCPAL RECORD e o�� /9 0TY SECRETARY AETgq�Til Ft WORTHo TX Monnie Louise Reid Request to Exercise Renewal CSC 49869 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. �c w;oj%. Steve Streiffert Assistant Director, IT Solutions Department OFFICIAL RECORD CITY SECRE'T'ARY ACo® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYY1� ik. 08/3112018 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTA T NAME: Hiscox Inc a/c No Ext): (888)202-3007 ac No): 520 Madison Avenue ADDRESS: contact@hiscox.com 32nd Floor INSURERS AFFORDING COVERAGE NAIC# New York,NY 10022 INSURER A: Hiscox Insurance Company Inc 10200 INSURED INSURER B: MONNIE LOUISE REID INSURER C: 5320 DUSTY RD INSURER D: INSURER E: ATHENS TX 75752 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES,LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR Y EFF POLICY NUMBER MMIDDIYYYY MM/DD/ YYYY LIMITS LTR COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DA AGE ToRENTED CLAIMS-MADE LJ OCCUR PREM SES Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑JECTPRO F—] LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident) ccident $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS Per accident UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED i I RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANYPROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $ OFFICERIMEMBEREXCLUDED? F—] NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS belowE.L.DISEASE-POLICY LIMIT $ Professional Liability Each Claim: $500,000 A UDC-2075856-EO-18 10115/2018 10/15/2019 Aggregate: $ 500,000 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE ` 471 i @ 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Soto, Vania Elizabeth From: Agee-Dow, Kathryn Sent: Tuesday,January 8, 2019 3:59 PM To: Soto, Vania Elizabeth Subject: RE:Attorney Signature Request to Exercise Renewal Option documents do not require attorney signature,just Susan Alanis and Mary Kayser Kathy From:Soto,Vania Elizabeth Sent:Tuesday,January 08, 2019 3:49 PM To:Agee-Dow, Kathryn<Kathryn.Agee-Dow@fortworthtexas.gov> Subject:Attorney Signature The contracts with Tyler Technologies and Monnie Louise Reid do not have JB Strong's signature. Vania E. Soto Administrative Assistant City Secretary's Office 817-392-6090 Vania.Soto@fortworthtexas.gov 1