HomeMy WebLinkAboutContract 63933Docusign Envelope ID: 707A5987-11 FE-4A63-910E-3AB7C39C32F5
CSC No. 63933
Agreement for Access to Electronic Medical Record System between
Tarrant County Hospital District d/b/a JPS Health Network and
the City of Fort Worth
THIS AGREEMENT for Access to Electronic Medical Record System ("Agreement") is
entered into between Tarrant County Hospital District d/b/a JPS Health Network ("District"), a
unit of local government and more specifically a county hospital district created and operating
under Chapter 281 of the Texas Health and Safety Code, and the City of Fort Worth, a unit of
local government ("Outside Entity"). The District and Outside Entity may be referred to
individually as a "Party" to this Agreement and they may be referred to collectively as the "Parties"
to this Agreement.
WHEREAS, District utilizes certain systems which allow users to remotely access patient
electronic health records (the "System") among the District, other health care providers affiliated
with District, physicians and physician practices with medical staff privileges at the District
hospitals or another health care provider and other providers of health care items and services in
and around Tarrant County, Texas;
WHEREAS, the System will allow Authorized Users (defined below) of Outside Entity to
view and retrieve the electronic health records ("EHR") of their patients for the purpose of
treatment, payment, and certain health care operations to the extent permitted without
authorization by the Administrative Simplification subtitle of the Health Insurance Portability and
Accountability Act of 1996, and the rules and regulations promulgated thereunder, as may be
amended from time to time (collectively, "HIPAA"), and further subject to the Recovery and
Reinvestment Act of 2009 ("ARRA"), including its provisions commonly known as the Health
Information Technology for Economic and Clinical Act ("HITECH Act") and rules and
regulations promulgated thereunder, as may be amended from time to time;
WHEREAS, District believes that the use of EHR technology by Outside Entity would
substantially improve the quality of health care provided in and around Tarrant County, Texas and
would therefore like to allow access to the System by Outside Entity, subject to the restrictions
and other requirements set forth in this Agreement;
WHEREAS, Outside Entity provides professional or other medical services to District
patients, but does not have a contract with District for access to EHR;
WHEREAS, Outside Entity has agreed to use the System to improve the quality and
efficiency of the medical services Outside Entity provides to District patients; and
NOW, THEREFORE, in consideration of the premises, the mutual agreements and
covenants herein contained, and other good and valuable consideration, the receipt and sufficiency
of which is hereby acknowledged, the parties hereto do hereby agree as follows:
1. Term. This Agreement is effective on the date of last signature, and shall continue
thereafter from year to year unless earlier terminated by either Party in accordance with the
Agreement.
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2. System Access.
A. Subject to the terms and conditions of this Agreement, District hereby grants
Outside Entity non -transferable and non-exclusive access to the System to Outside Entity's
medical, administrative and clinical staff who are otherwise permitted under state and federal law
to access the protected health information ("PHI") of District patients (collectively "Authorized
Users"), to electronically access and use the System solely for storing, processing and displaying
medical records and other information, images and content related to the provision of healthcare
to District patients who are patients of such Medical Providers (the "System License"). Outside
Entity understands and warrants that such access and use shall be limited to that achieved through
unique access codes provided to each individual Authorized User by District, and that each
Authorized User shall be prohibited from using another Authorized User's access code to access
and/or use the System. Outside Entity further acknowledges and understands and acknowledges
that District may terminate individual Authorized Users' access and/or the entire System License
at any time for any reason without penalty, regardless of any effect such termination may have on
Outside Entity's operations.
B. Outside Entity acknowledges and agrees that any hardware, software, network
access or other components necessary for Outside Entity to access and use the System must be
obtained separately by Outside Entity. District shall not be responsible for the procurement,
installation or maintenance of any necessary components, and District makes no representations
or warranties regarding the components whatsoever. Any fees for the components shall be borne
by Outside Entity and paid directly to the suppliers of the components.
3. Use or Disclosure of Protected Health Information.
A. Outside Entity shall not use or disclose PHI received from District in any manner
that would constitute a violation of federal or state law including, but not limited to, Texas Health
and Safety Code Ch. 181, HIPAA and HITECH. Outside Entity shall ensure that its directors,
officers, employees, contractors, and agents use or disclose PHI received from, or created or
received on behalf of District only in accordance with the provisions of this Agreement and federal
and state law. Outside Entity shall not disclose PHI in any manner other than as permitted by this
Agreement. Outside Entity further agrees that all information accessed through the System will be
maintained in the strictest confidentiality and in the same manner as Outside Entity safeguards the
confidentiality of other patient care records, or as required by state and federal law.
B. Outside Entity agrees to implement and utilize the System and shall provide District
with access to a patient's EHR that are created, maintained, transmitted, or received using the
System when such patient is also a patient of District solely for the purposes of treatment, payment,
or health care operations to the extent permitted without patient authorization by HIPAA. Outside
Entity shall use the System in accordance with any network security policies issued by District
from time to time.
C. District and Outside Entity shall comply in all material respects with the standards
for privacy of individually identifiable health information of the Administrative Simplification
subtitle of HIPAA. District and Outside Entity recognize their status as "covered entities"
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under HIPAA and agree to carry out their responsibilities under this Agreement in
accordance with such status.
4. Process for Requesting System Access.
A. Outside Entity shall provide District with the name and direct contact information
for its Privacy Officer, and shall notify District of any change in such contact person. Outside
Entity shall also designate a liaison to coordinate user access (which person can also be the Privacy
Officer). The liaison is responsible for managing the modification and termination for accounts
that the Outside Entity is provided. Before access to the System, each Authorized User shall select
"I ACCEPT" to the terms of the online confidentiality statement (the "Confidentiality Statement")
in the form provided herein as Exhibit A, attached hereto and incorporated herein by reference, as
that form may be amended from time to time. Outside Entity shall ensure that each Authorized
User approved for access under this Agreement adheres to the requirements of this Agreement and
the Confidentiality Statement. Each Authorized Individual shall also complete, in a form and in a
manner to be determined by District, training regarding the requirements of HIPAA as they pertain
to System access.
B. For purposes of this Agreement, access to the System as Authorized Users shall be
permitted only for such categories of employees of Outside Entity who have a reasonable need to
access PHI of District patients for purposes of carrying out their duties to such patients. If any
Authorized User is separated from employment or is no longer an agent of Outside Entity
for any reason (including but not limited to termination or voluntary separation), or placed
under administrative suspension or extended personal leave that would preclude access to
any electronic systems (a "separation"), Outside Entity agrees to notify District of the
separation AS SOON AS POSSIBLE but in no even later than twenty-four (24) hours after
such separation occurs. Such initial notification shall be made to the District via email at
ipscarelink(d,ipshealth.ora. Outside Entity shall also provide the written notice of such
separation within three (3) business days of the separation as follows:
Tarrant County Hospital District
Attn: Chief Compliance Officer
1500 S. Main St.
Fort Worth, TX 76104
With a copy to: Tarrant County Hospital District
Attn: Chief Information Security Officer
1500 S. Main St.
Fort Worth, TX 76104
C. Outside Entity further agrees, ON EACH ANNIVERSARY DATE OF THIS
AGREEMENT, to validate that each of the Authorized Users continue to require access to
the System and continue to be employees or agents of Outside Entity.
5. Safeguards Against Unauthorized Use or Disclosure of Information. Outside
Entity agrees that it will implement appropriate administrative, technical, and physical safeguards
to mitigate risks of unauthorized access, use or disclosure of electronic PHI as required under the
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HIPAA Security Rule. Outside Entity agrees to comply with all federal and state laws and
regulations regarding privacy, security, and electronic exchange of health information, as currently
enacted or amended in the future.
6. Data Ownership. Outside Entity acknowledges and agrees that District owns all
rights, interests and title in and to its data and that such rights, interests and title shall remain vested
in District at all times. Outside Entity shall not compile and/or distribute analyses to third parties
utilizing any data received from, or created or received on behalf of District without express written
permission from the District Compliance Officer (or designee).
7. Reporting of Unauthorized Use or Disclosure of PHI.
A. Unauthorized Use or Disclosure. Outside Entity shall, within three (3) calendar
days of becoming aware of an unauthorized use or disclosure of PHI by Outside Entity, its officers,
directors, employees, contractors, agents or by a third party to which Outside Entity disclosed PHI,
report any such disclosure to District in writing. Such notice shall be made to the following:
Tarrant County Hospital District
Attn: Chief Compliance Officer
1500 S. Main St.
Fort Worth, TX 76104
B. Potential Data Security Breach. If at any time Outside Entity has reason to believe
that PHI transmitted pursuant to this Agreement may have been accessed or disclosed without
proper authorization and contrary to the terms of this Agreement, Outside Entity shall immediately
give District notice and take actions to eliminate the cause of the breach and mitigate the damage
caused. To the extent District deems warranted, in its sole discretion, District will provide notice
or require Outside Entity to provide notice to individuals whose PHI may have been improperly
accessed or disclosed.
C. Compliance. District has the right, at Outside Entity's sole cost and expense, at any
time, to monitor, audit, and review activities and methods in implementing this Agreement in order
to assure compliance therewith, within the limits of Outside Entity's technical capabilities.
8. Third Party Access. Outside Entity shall obtain the written approval of District
prior to allowing any agent or subcontractor access to PHI that is created or received on behalf of
the District. In the event that District consents to such third -party access on a case -by -case basis,
Outside Entity shall ensure that the agent or subcontractor agrees to be bound by the same
restrictions, terms and conditions that apply to Outside Entity through this Agreement. Outside
Entity shall require that any agent or subcontractor notify in writing Outside Entity of any instances
in which PHI is used or disclosed in an unauthorized manner. Outside Entity shall cure the breach
of confidentiality and end the violation or shall terminate the agency agreement or subcontract.
9. Availability of Books and Records. Outside Entity shall make its internal
practices, books and records relating to the use and disclosure of PHI received from District, or
created or received on behalf of District, available to the Secretary of the U.S. Department of
Health and Human Services for purposes of determining District's and Outside Entity's
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compliance with the HIPAA standards. Outside Entity promptly shall provide to District a copy
of any documentation that Outside Entity provides to the Secretary.
10. Audits; Investigations; Sanctions. District reserves the right to monitor, review
and investigate (i.e. audit) reported and identified failures to comply with this Agreement and
impose nonmonetary appropriate sanctions. Outside Entity shall cooperate fully with District's
audit activities. Sanctions may include, but are not limited to, the termination of this Agreement,
termination of Outside Entity's access, or termination of individual Authorized User's access.
District reserves the right to report unprofessional conduct to appropriate licensing or other
regulatory authorities. Outside Entity shall fully cooperate with District in order to adequately
investigate complaints received involving the Outside Entity's employees or agents. Outside
Entity shall have a sanctions policy, produce it upon request, and discipline their employees or
agents for all breaches involving District PHI in accordance with the HIPAA Privacy Rule. Outside
Entity understands that lack of strict adherence to this section, as determined by District in its sole
discretion, allows District to immediately void this Agreement and all associated access privileges.
11. Immediate Termination. District may terminate Outside Entity's participation in
this Agreement immediately without liability for such termination, in the event District determines,
in its sole discretion, that Outside Entity, or Outside Entity's directors, officers, employees,
contractors or agents have violated a material provision of this Agreement.
12. Indemnification. To the extent permitted by the Texas Constitution, laws, and
rules, and without waiving any immunities or defenses available to Outside Entity as a
governmental entity, Outside Entity agrees to indemnify and hold harmless District, its governing
board, officers, employees and agents, from and against any and all claims, costs, losses, damages,
liabilities, expenses, demands, and judgments, including litigation expenses and attorney's fees,
which may arise from Outside Entity's performance under this Agreement or negligent acts or
omissions of its subcontractors, agents, or employees, including, but not limited to, any penalties,
claims or damages arising from or pertaining to a breach of this Agreement, or the violation of any
state or federal law applicable to the use, disclosure or protection of PHI subject to this Agreement.
Such indemnification shall include, but shall not be limited to: (a) the full cost of providing
required notice of the security breach to individuals affected by the unauthorized acquisition and/or
misuse of the District's PHI, including the costs to retain an outside consulting firm, vendor or
outside attorneys to undertake the effort; (b) the full cost of providing required notice to
government agencies, credit bureaus, and/or other required entities; (c) the cost of providing
individuals affected by the unauthorized acquisition and/or misuse of the District's PHI with credit
protection services designed to prevent fraud associated with identity theft crimes for a specific
period not to exceed twelve (12) months, to the extent the misuse or disclosure of the affected
individual's personal data could lead to a compromise of the data subject's credit or credit
standing; (d) reasonable call center support for such affected individuals for a specific period not
to exceed sixty (60) days; reasonable fees associated with computer forensics work required for
security incident investigations, and (f) appealable fines or penalties assessed by governments or
regulators for Outside Entity's failure to comply with its defined privacy and/or security
obligations and directly attributable to Outside Entity's unauthorized disclosure or misuse.
13. Insurance. During the term of this Agreement, Outside Entity, at its sole cost and
expense shall provide professional liability insurance which includes insurance for negligent
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and intentional breaches of patient privacy and security regulations in a type and amount
sufficient to cover its obligations hereunder, but in any event no less than a minimum amount of
$5,000,000 per occurrence and $10,000,000 in the aggregate. The above notwithstanding, Outside
Entity is a unit of government and may elect to self -insure to satisfy the obligations of this
provision pursuant to Chapter 2259 of the Texas Government Code, entitled "Self -Insurance by
Governmental Units," and therefore is not required to purchase insurance.
14. No Offshore PHI. Without the prior written approval of District, Outside Entity
shall neither (i) create, receive, maintain, or transmit District's PHI outside the geographic
boundaries of the United States, nor (ii) provide, transmit, or allow access to District's PHI to any
person or entity located outside the geographic boundaries of the United States, including
employees, agents or other representatives of that person or entity.
15. Relief. Outside Entity agrees that the breach or threatened breach of this
Agreement may cause irreparable harm to District and/or individuals, that District may not have
an adequate remedy at law, and that District shall therefore be entitled to injunctive or other
equitable relief to enforce this Agreement without a further evidentiary showing and shall not be
required to post bond in excess of $1 (USD).
16. Entire Agreement. This Agreement constitutes the entire agreement between the
parties regarding access to the System, and supersedes all prior oral or written agreements,
commitments, or understandings concerning the matters provided for herein.
17. Amendment. No supplement, modification, or amendment of any term, provision,
or condition of this Agreement shall be binding or enforceable on either party hereto unless in
writing signed by both parties.
18. Governing Law. This Agreement shall be governed by the laws of the State of
Texas without regard to its conflict of laws provisions and the venue of any litigation arising from
this Agreement shall be in the District Courts of Tarrant County, Texas or the United States District
Courts of the Northern District of Texas located in Fort Worth, Texas. The venue of any dispute
resolution activity shall be in Fort Worth, Tarrant County, Texas.
19. Waiver. The failure to comply with or to enforce any term, provision, or condition
of this Agreement, whether by conduct or otherwise, shall not constitute or be deemed a waiver of
any other provision hereof, nor shall such failure to comply with or to enforce any term, provision,
or condition hereof constitute or be deemed a continuing waiver. No waiver shall be binding
unless executed in writing by the party making the waiver.
20. Termination for Convenience. Either party may terminate this Agreement upon
thirty (30) days written notice to the other Party.
21. Parties Affected. Nothing in this Agreement, whether express or implied, is
intended to confer upon any individual or entity, other than the parties hereto (and their respective
heirs, representatives, successors, and permitted assigns), any rights or remedies hereunder or
otherwise. Nothing in this Agreement is intended to relieve or discharge any liability of any party
hereto or any third party. No provision in this Agreement shall give any individual or entity any
right of subrogation against any party hereto.
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22. Severability. Should any part, term, or provision of this Agreement be declared to
be invalid, void, or unenforceable, all remaining parts, terms, and provisions hereof shall remain
in full force and effect, and shall in no way be invalidated, impaired, or affected thereby. Each
invalid provision shall be revised only to the extent necessary to bring it within the requirements
of such law or regulation.
23. Assignment. No party to this Agreement may assign this Agreement without the
prior written consent of the other party.
24. Relationship of the Parties. None of the provisions of this Agreement are
intended to create, and none shall be deemed or construed to create, any relationship between the
parties, other than that of independent contractors. This Agreement shall not create the relationship
of employer -employee, agency, partnership, or joint venture. Neither party shall have the right or
power in any manner to unilaterally obligate the other to any third parry, whether or not related to
the purpose of this Agreement.
25. Texas Public Information Act. The Parties acknowledge that each is a
governmental body under Chapter 552 of the Texas Government Code and that certain information
that is collected, assembled, or maintained in connection with the transaction of official business
by a governmental body is considered public information potentially subject to disclosure pursuant
to a valid Texas Public Information Act ("TPIA") request. Each Party's confidential information
including trade secrets, certain financial information, and proprietary information may be subject
to an exception to disclosure under Chapter 552 of the Texas Government Code, Subchapter C. If
a TPIA request is made on either Party (the "Requested Party") to disclose the other Party's
information that may be subject to an exception from disclosure, the Requested Party will (i)
promptly notify the other Party of such request for disclosure, and (ii) decline to release such
information and file a written request with the Texas Attorney General's office seeking a
determination as to whether such information may be withheld.
IN WITNESS WHEREOF, District and Outside Entity have caused this Agreement to be
duly executed on the day and year first above written.
City of Fort Worth
By: Z�J
, 9,,��
William Johnson
Name:
Title: Assistant City Manager
Date: 09/10/2025
EpicCare Link Access Agreement 061225.docx
Tarrant County Hospital District
d/b/a JPS Health Network
gnetl by:
By:emu (kaitn So n
Name: Kimberly Hodgkinson
Title: EVP/CFO
Date: 08/25/25 1 9:43 AM CDT
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Docusign Envelope ID: 707A5987-11 FE-4A63-910E-3AB7C39C32F5
CITY OF FORT WORTH INTERNAL ROUTING PROCESS:
Approval Recommended:
James Davis (Sep 10, 2025 08:34:48 CDT)
By:
Name:
Title:
Jim Davis
Fire Chief
Approved as to Form and Legality
By:
Name: Taylor C. Paris
Title: Assistant City Attorney
Contract Authorization:
M&C:
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.
By:
Name
Title:
Ekeivla en
Brenda Ray (Sep 10, 2025 67:46:50 CDT)
BrendaRay
Fire Purchasing Manager
City Secretary:
By:
Name: Jannette S. Goodall
Title: City Secretary
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Docusign Envelope ID: 707A5987-11 FE-4A63-910E-3AB7C39C32F5
Exhibit A
The protection of health and other confidential information is a right protected by law and enforced by fines,
criminal penalties as well as employer policy.
Safeguarding confidential information is a fundamental obligation for all persons accessing confidential information.
Your clicking on "I AGREE" at the end of this statement will commit you to that obligation, and WILL be used as
proof that you understand and agree to the stated basic duties and facts regarding privacy.
Read it carefully.
What you agree to in signing this statement:
1. I agree to maintain the privacy and security of all District confidential information that I am entitled to access.
2. I agree to: a) access confidential information to the minimum extent necessary for my assigned duties; and b) disclose
such information only to persons authorized to receive it.
3. I understand and agree to the following:
a. District tracks all user IDs used to access electronic records. Those IDs enable discovery of inappropriate access to
EITHER employee records or patient records.
b. Inappropriate access and/or unauthorized release of confidential or protected information will result in disciplinary action,
up to and including termination of employment, and will result in a report to authorities charged with professional licensing,
enforcement of privacy laws and prosecution of criminal acts. I further understand and agree that inappropriate access and/or
unauthorized release of confidential or protected information may result in temporary and/or permanent termination of my
access to District electronic records.
c. That I will be assigned a User ID & a one-time use activation code. I agree to immediately select and enter a new password
known only to me. I understand I may change my password at any time, and will do so based on District established policy
and/or when prompted. I understand that I am to be the only individual using and in possession of my confidential password.
I am aware that the User ID and password are equivalent to my signature. Also, I am aware that I am responsible for any
use of the system utilizing my User ID and password. This includes data entered, viewed, printed or otherwise manipulated.
If I have reason to believe that my password has been compromised I will immediately report this information to District
and I will also immediately change my password. I understand that User IDs cannot be shared. Inappropriate use of my ID
(whether by me or anyone else) is my responsibility and exposes me to severe consequences.
4. Confidential Health Information includes but is not limited to:
Any individually identifiable information in possession or derived from a provider of health care regarding a patient's
medical history, mental, or physical condition or treatment, as well as the patients and/or their family members records, test
results, conversations, research records and financial information. (Note: this information is defined in the Privacy Rule as
"protected health information.") Examples include, but are not limited to:
Physical medical and psychiatric records including paper, photo, video, diagnostic and therapeutic reports,
laboratory and pathology samples;
Patient insurance and billing records;
Centralized and/or department based computerized patient data and alphanumeric radio pager messages;
5. Confidential Employee & Business Information that is not available in the public domain includes but is not limited
to:
- Employee home telephone number and address;
- Spouse or other relative names;
- Social Security number or income tax withholding records;
- Information related to evaluation of performance;
- Other such information obtained from District's records, which if disclosed, would constitute an
unwarranted invasion of privacy; or disclosure of protected or confidential information that would cause
harm to District.
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d docusign.
Certificate Of Completion
Envelope Id: 707A5987-11 FE-4A63-910E-3AB7C39C32F5
Status: Delivered
Subject: iContracts - Signature Request on Document(s). Contract 1335249
Source Envelope:
Document Pages: 9 Signatures: 1
Envelope Originator:
Certificate Pages: 2 Initials: 0
Frank Deeds
AutoNav: Enabled
1350 S. Main Street
Envelopeld Stamping: Enabled
Suite 1350
Time Zone: (UTC-06:00) Central Time (US & Canada)
Fort Worth, TX 76104
FDeeds@jpshealth.org
IP Address: 52.207.176.51
Record Tracking
Status: Original Holder: Frank Deeds
Location: DocuSign
Aug 25, 2025 1 09:20 FDeeds@jpshealth.org
Signer Events Signature
Timestamp
Brenda
Sent: Sep 9, 2025 1 17:06
Brenda. Ray@fortworthtexas.gov
Viewed: Sep 10, 2025 1 07:21
Security Level: Email, Account Authentication
(Optional)
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Kimberly Hodgkinson
KHodgkinso@jpshealth.org
EVP/CFO
JPS Health Network
Security Level: Email, Account Authentication
(Optional)
Electronic Record and Signature Disclosure:
Not Offered via Docusign
In Person Signer Events
Editor Delivery Events
Agent Delivery Events
Intermediary Delivery Events
Certified Delivery Events
Carbon Copy Events
Daniel Ebbett
daniel.ebbett@fortworthtexas.gov
Security Level: Email, Account Authentication
(Optional)
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Taylor Paris
Taylor. Paris@fortworthtexas.gov
Security Level: Email, Account Authentication
(Optional)
Electronic Record and Signature Disclosure:
Not Offered via Docusign
Signed by:
E
K,btyV (�o�a iwsbvu
9EA393FB6F554EB...
Signature Adoption: Pre -selected Style
Using IP Address: 206.201.92.45
Signature
Status
Status
Status
Status
Status
COPIED
COPIED
Sent: Aug 25, 2025 1 09:32
Viewed: Aug 25, 2025 1 09:43
Signed: Aug 25, 2025 1 09:43
Timestamp
Timestamp
Timestamp
Timestamp
Timestamp
Timestamp
Sent: Aug 25, 2025 1 10:32
Viewed: Aug 26, 2025 1 12:57
Sent: Sep 9, 2025 1 17:06
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted Aug 25, 2025 1 09:32
Certified Delivered Security Checked Aug 25, 2025 1 09:43
Signing Complete Security Checked Aug 25, 2025 1 09:43
Payment Events Status Timestamps