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Home My WebLink About056905-R4 - General - Contract - FMLA Source, Inc.Docusign Envelope ID: 35498BA4-34B4-4308-BOOD-4E4059FO6D16 CSC No. 56905-R4 CITY OF FORT WORTH CONTRACT RENEWAL NOTICE March 5, 2026 FMLA Source, Inc. Attn: Adam Gotskind 455 N. Cityfront Plaza Dr. Chicago, IL 60611 Re: Contract Renewal Notice City Secretary Contract No. 56905 (the "Contract") Renewal Term NoA: April 01, 2026, to March 31, 2027 The above referenced Contract with the City of Fort Worth expires on March 31, 2026 (the "Expiration Date"). Pursuant to the 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 the Contract for an additional one (1) year period, which will begin immediately after the Expiration Date. All other terms and conditions of the Contract remain unchanged. Please return this signed acknowledgement letter, along with a copy of your quote for charges for the new renewal term and a current insurance certificate, to the address set forth below, acknowledging receipt of the Contract Renewal Notice. Failure to provide a signed acknowledgment does not affect the renewal. Please log onto PeopleSoft Purchasing at http://fortworthtexas.gov/purchasiniz to ensure 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, Erin Roden, MPA Sr. Contract Compliance Specialist 817-392-7455 OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Contract Renewal Page 1 of 2 Docusign Envelope ID: 35498BA4-34B4-4308-BOOD-4E4059FO6D16 CSC No. CITY OF FORT WORTH: By: AK%—M8&r— Dianna Giordano (Apr 1, 2026 09:41:00 CDT) [dame: Dianna Giordano Title: Assistant City Manager Date: 04/01 /2026 AL [dame: Kristen Smith Title: Human Resources Director ATTEST: Fon'T°°o Q Zi ..�a,.2¢.e� °daaaosoa By: a [Name: Jannette Goodall Title: City Secretary VENDOR: FMLA SOURCE, INC. 3/24/2026 Date: 20253/24/26-- 81 d by: C "' "Kt By. — DAOD7EB2B988C88._ Name: Adam (iotskind Title: Counsel 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. ,y. ErLw L. Ro-d e� Erin Roden Sr. Contract Compliance Specialist, Human APPROVED AS TO FORM AND LEGALITY: By: Name: Keanan Matthews Hall Title: Sr. Assistant City Attorney CONTRACT AUTHORIZATION: M&C: 25-0160:02-25-25 Form 1295: N/A OFFICIAL RECORD CITY SECRETARY FT. WORTH, TX Contract Renewal Page 2 of 2 M&C Review Page 1 of 2 CITY COUNCIL AGENDA Create New From This M&C DATE: 2/25/2025 REFERENCE **M&C 25- NO.: 0160 Official site of the City of Fort Worth, Texas FoRTWORT11 "111v LOG NAME: 14FMLAANDADASERVICES CODE: C TYPE: CONSENT PUBLIC NO HEARING: SUBJECT: (ALL) Authorize Amendment No. 2 to the Agreement with FMLASource, Inc. for Family Medical Leave Act and American Disabilities Act Services to Increase Spending Authority by $100,000.00 for a Total Annual Spending Authority Up to $316,240.00 for the Second Renewal Option and All Remaining Renewal Options, Based on Current Needs and Line Item Pricing in the Original Agreement RECOMMENDATION: It is recommended that the City Council authorize Amendment No. 2 to the agreement with FMLASource, Inc. (City Secretary Contract No. 56905) to increase spending authority by $100,000.00 for a total annual spending authority up to $316,240.00 for the second renewal option and all remaining renewal options, based on current needs and line item pricing in the original agreement. DISCUSSION: The purpose of this Mayor and Council Communication (M&C) is to increase the annual spending authority for FMLASource, Inc. by $100,000.00 per year for the remainder of the contract, and subsequent renewal options for a total annual spending authority up to $316,240.00 The City Council approved the contract with FMLASource, Inc. on November 30, 2021 (M&C 21-0886; City Secretary Contract No. 56905). The initial M&C approval amount was $216,240.00 annually. The charges for the services provided by FMLASource, Inc. are on a line item basis with the final calculation based on the number of city employees. The line item cost has not changed since the inception of the agreement. However, the number of employees since the inception of the contract has increased. Approval of this M&C would authorize an increase in spending authority by an annual amount of $100,000.00 for a total annual amount up to $316,240.00 for the second renewal option and all remaining renewal options. The estimated increase factors in the current and projected number of city employees subject to change. FISCAL INFORMATION/CERTIFICATION: The Director of Finance certifies that funds are available in the current operating budget, as previously appropriated, in the General Fund to support the approval of the above recommendation and execution of an amendment to the agreement. Prior to any expenditure being incurred, the Human Resources Department has the responsibility to validate the availability of funds. TO Fund Department Account I Project Program Activity Budget Reference # Amount ID ID Year (Chartfield 2) FROM 1�t Department Account Project Program Activity Budget Reference # Amount ID ID Year (Chartfield 2) http://apps.cfwnet.org/council_packet/mc_review.asp?ID=33025&councildate=2/25/2025 3/20/2025 M&C Review Page 2 of 2 Submitted for City Manager's Office by: Originating Department Head: Additional Information Contact: ATTACHMENTS Jesica L. McEachern (5804) Dianna Giordano (7783) Shannon Davis (6140) Sandra Huerta (7789) 14FMLAANDADASERVICES funds availability.pdf (CFW Internal) FID 14FMLAANDADASERVICES Amendment.xlsx (CFW Internal) http://apps.cfwnet.org/council_packet/mc_review.asp?ID=33025&councildate=2/25/2025 3/20/2025 FORT WORTH. City Secretary's Office Contract Routing & Transmittal Slip Contractor's Name: FMLA Source, Inc. Subject of the Agreement: FMLA Claims Management & Processing, Customer service & Management Support FMLA Claim tracking, documentation, and reporting. M&C Approved by the Council? * Yes 0 No ❑ If so, the M&C must be attached to the contract. Is this an Amendment to an Existing contract? Yes ❑ No 0 N/A If so, provide the original contract number and the amendment number. Is the Contract "Permanent"? *Yes ❑ No 0 If unsure, see backpage for permanent contract listing. Is this entire contract Confidential? *Yes ❑ No 0 If only specific information is Confidential, please list what information is Confidential and the page it is located. N/A N/A Effective Date: April 1, 2026 If different from the approval date. Expiration Date: March 31, 2027 If applicable. Is a 1295 Form required? * Yes ❑ No ED *If so, please ensure it is attached to the approving M&C or attached to the contract. Project Number: If applicable. N/A *Did you include a Text field on the contract to add the City Secretary Contract (CSC) number? Yes 0 No ❑ Contracts need to be routed for CSO processing in the followingorder: rder: 1. Katherine Cenicola (Approver) 2. Jannette S. Goodall (Signer) 3. Allison Tidwell (Form Filler) *Indicates the information is required and if the information is not provided, the contract will be returned to the department.