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IT16-041 - Original - Innotas - 2016 Innotas Annual Service Agreement - 02/01/2016
tu4� Record (®mil !S KENT Document CONTRACT COVER SHEET This is to be completed by the Contract Manager prior to submission to City Clerks Office. All portions are to be completed. If you have questions, please contact City Clerk's Office. Vendor Name: Innotas Vendor Number: 1203909 JD Edwards Number Contract Number: IT ILy _ N This is assigned by City Clerk's Office Project Name: 2016-2017 FastTRACK Implementation Services Description: ❑ Interlocal Agreement ❑ Change Order ❑ Amendment ® Contract ❑ Other: Contract Effective Date: 2/1/16 Termination Date: 1/31/17 Contract Renewal Notice (Days): 30 days Number of days required notice for termination or renewal or amendment Contract Manager: Lynnette Smith Department: Information Technologies Contract Amount: $19,946.52 Approval Authority: ® Department Director ❑ Mayor ❑ City Council Detail: (i.e. address, location, parcel number, tax id, etc.): I As of: 08/27/14 INNOTAS 1NNOTAS Invoice 1 I I Sutter Street Suite 300 , San Francisco,CA 94104 ✓# (415)263-9759 01/31/2016 5406 djackson@innotas.com Itt)5 _ ` Due:`Qa4a'� Net30 03/01/2016 City of Kent,WA City of Kent Information Technoloy Lynette Smith-Admin Services Supervisor,IT 220 Fourth Ave. South Kent,WA 98032 f4mau�ai~©ue �= Et�oloses3 $19,216.00 Please detach top portion and return with your payment �y Kattelyn Snider •Annual Service Fee for the Tnnotas Application February 1,2016 to January 31,2017 2,216.00 4 Full Users,4 Time Users •FastTRACK implementation Services 16,000.00 ' WIRE FUNDS TO: ComericaBank 333 W. Santa Clara Street San Jose,CA 95113 Account Name: Innotas Account No. 1894345220 ABA No. 121137522 PLEASE REMIT TO:Innous It I Sutter St,Ste 300,San Francisco,CA 94t04 ORDER FORM ® conftdentiai INNOTAS Company Address 111 Sutler Street,Suite$00 Order Number KS2016128 San Francisco,CA 04104 Created Date 112 812 01 6 Phone (415)263-9800 Expiration Date 1/2912016 Fax (415)795.7228 Prepared By Katelyn Snider Account Name City of Kent,WA Contact Name Tricis Callahan Billing Address 220 4th Ave S Email tallahan@kanlwa.gov Kent,WA 98032 Phone 253-856-4605 US Commencement 211/'2016 Contract Term 1 Year Date Payment Terms Not 30 End Date 118112017 Billing Frequency Up front i Innolas License Fee Includes production Instance,web services API,all upgrades,support and maintenance. Discounted licenses and one time fees an this Order represent a$11,216 savings to City of Kent contingent on being executed by the Expiration Date. Product License Term Quantity List Price Sales Price Total Prim Fasflrack One Time Fee 1.00, $25,000.00 $16,000.00 $16,000.00 Innolas Full User Recurring License Fee 4.00 $66o.00 $41a.00 $1,640.00 Innolas Time User Recurring License Fee 4,00 $240.00 $144.00 $576.00 Total Recurring Fee $2,216,00 Total One Time Fee $16,000.00 Total Price $18,216.00 This legally binding Order Form Is governed by the Innotas General Terms and Conditions as set forth at ICI http,y/ww .Innotas.comlGenerelfarms/innolasGeneratTerms.pdf(the"General Terms'?,which are hereby incorporated into Ihis Order Form by reference.Client's signature below constitutes acceptance orlhose General Terms.In the event of a conf7lct between the General Terms and this Order Farm,this Order Form shall control. City of Kent,WA Innotas,a Callforn -torpor 1� Name: E Yd Name: C Signet e; Signature: CZlE" LQ1rAkiR 'lice Prestdeat Safer Title: Title: I, Dale: 1 Dale: New Vendor ❑ Reactivate Vendor Vendor Setup Form ❑ Address Change KBE„NT® nge To be filled out by Vendor ONLY vendor Number FINANCE 220 Fourth Avenue South • Kent,WA 98032-5895• Phone: (253) 856-5235 o Fax: (253) 856-6200 An Incomplete form will create a delay in our payment(s)to you and your payments) could be subJect to the IRS required back-up withholding. Name, as it will appear on check (NO ABBREVIATIONS) Doing Business As (if different than name on check) III SU-twf Stf'cC. , Si,titE �0 1 Payment Address Business Address S( v� 171,6m6 CcI U-) `4f 104 City State Zip City State Zip onto i I,inol-c6 Phone Number Accounts Receivable Contact COi� .. check the appropriate box Corporation ❑ Government Agency ❑ IndividuaVSole Proprietor ❑ Non-Profit ❑ Partnership This business is ❑ Minority Owned ❑ Women Owned ❑ Both Minority and Women Owned J"Neither Will you provide medical services to the City of Kent? ................................................................Yes Will you provide legal services to the City of Kent? ....................................................................Yes to Will you provide services other than medical or legal to the City of Kent?......... ..........................ge No Will you provide parts, supplies or materials to the City of Kent?..................................................Yes No Do you pay sales tax to the State of Washington?........................................................................YE)5 No if exempt from Form 1099 reporting, and check your qualifying exemption reason below: j 1, Corporation, except there is no exemption for medical and healthcare payments or payments for legal services ❑ 2, Tax Exempt Charity under 501(a), or IRA ❑ 3. The United States or any of its agencies or instrumentalities ❑ 4. A state, the District of Columbia, a possession of the United States, or any of their political subdivisions ❑ 5. A foreign government or any of its political subdivisions Name (Owner of the Tax Payer Identification Number(EIN or SSN) as name appears on IRS or Social Security Administration Records): I n t) �QS j Social Security#: _ _._. or Federal TIN: Under penalties of perjury, I certify that: 1. The number shown on this form is my correct taxpayer Identification number(or I am waiting for a number to be issued to me)and, 2. 1 am not subject to backup withholding because: (a) I am exempt from backup withholding, or(b) I have not been notified by the Internal Revenue Service (IRS)that I am subject to backup withholding as a result of a failure to report all inter or dividends, or(c)the IRS has notified me that I am no longer subject to backup withholding. , I Signature► ( �� ('' ._ ,G �� Date ► Z ( � _ Ons2727 lndd,2J04 I + N o CD N N C) LO LO O L) It LQ Cl) p N r C) a0 00 r O) h � � O 7 N O IU) O N � pyj N to N m C � > E o o x <6 Q t C m o O U) i CDL) N O n.+ N � y W O U N m 7 m O CD CO N N U O M {j co CO F- r rnCD co < m of N N U Z is o 0 N 2 5 M co O <o 0 O CO 0 E U N O l ram+ N N 7 m N Q d d m U) LL E O O O > S � u� d L (D Q Al � C � N E ® v 20 ca a a 2 N �5 a /N/� V M N O V .O N "0 C ..0 Cl) 0 N N LO O U L E Y US co a M /+ E w NNM i m N o L C 0 3 w g rn ° c d > `n a E o N o caY U viQQN lyp i. N GL � d U N }I Q O N U O C C a-� 0 O mF„ O m USm Q N Y d = m N Q LL Y U N m o N 3 d � U O > L) 7 ` +Z U Yk N L Q LN . L)N C O O C 0 a a) O Y a � a .r _p 0 O OC N z0 � � 6 Y c ) N E U e z N m a G L m m E Wn � N La) c — rTri E m a) 0 ¢ d 0E ma) o a a N L 4. N .-% y Q. >\ rp :E R p 7 N 0 C. R F- 0 0 N 4 to 2