HomeMy WebLinkAboutCAG2019-010 - Amendment - #1 - UnifyHR, LLC - ACA Compliance Tracking Software - 10/01/2020ApprovalOriginator:Department:
Date Sent:Date Required:
Authorized to Sign:
o Director or Designee o Mayor
Date of Council Approval:
Budget Account Number:
Budget? o Yes o No
Grant? o Yes o No
Type:Review/Signatures/RoutingDate Received by City Attorney:Comments:
Date Routed to the Mayor’s Office:
Date Routed to the City Clerk’s Office:Agreement InformationVendor Name:Category:
Vendor Number:Sub-Category:
Project Name:
Project Details:
Agreement Amount:
Start Date:
Basis for Selection of Contractor:
Termination Date:
Local Business? o Yes o No*
*If meets requirements per KCC 3.70.100, please complete “Vendor Purchase-Local Exceptions” form on Cityspace.
Notice required prior to disclosure?
o Yes o No
Contract Number:
Agreement Routing Form
For Approvals, Signatures and Records Management
This form combines & replaces the Request for Mayor’s Signature and Contract Cover Sheet forms.
(Print on pink or cherry colored paper)
Visit Documents.KentWA.gov to obtain copies of all agreementsadccW22373_1_20
OK to sign, 9/21/2020
UHR Renewal Amendment v1.0
UNIFYHR AGREEMENT TO RENEW AND AMEND
("Renewal Agreement")
Whereas, the Parties to the Statement of Work ("Agreement") by and between City of
Kent "Client" and UnifyHR, LLC dated 9/1/2018 desire to a.) renew the Agreement
pursuant to the provisions of Section 15.1, b) supersede and replace the Fee Exhibit in
the Agreement with the attached RENEWAL FEE EXHIBIT and c) to take effect
10/1/2020, and remain effective through 9/30/2022.
This Renewal Agreement supersedes any previous Renewal Agreements currently in
place.
This Renewal Agreement may be executed in two (2) or more counterparts, each of
which shall be deemed an original and all of which, together, shall constitute one and the
same instrument. Facsimile execution and delivery of the Amendment is legal, valid, and
binding for all purposes.
Executed this 10/1/2020, by their respective duly authorized representatives:
City of Kent UNIFYHR, LLC
By: By:
Name: Name: A. Allen Gehrki
Title: Title: President and CEO
Date: Date: 06/10/2020
Dana Ralph
Mayor
09/22/2020
UHR Renewal Amendment v1.0
RENEWAL FEE EXHIBIT
City of Kent
This schedule of fees for services enumerated below is subject in all respects to the
Statement of Work between Client and UnifyHR ("Agreement"). In the event of a conflict
between the Service Description and the Agreement, the Agreement shall prevail.
Service Fee Description
General Implementation Fee N/A
Offer of Coverage and/or Affordability Tracking Setup N/A
6055 and 6056 Setup Fee N/A
Offer of Coverage and/or Affordability Tracking PEPM $0.77
6055 and 6056 Fulfillment and Distribution $3.42 Per Notice
Mid-Year New Acquisition Setup fee Included
Mid-Year New FEIN Setup Fee Included
Annual Plan Maintenance Fee
Per each 5 FEINs $1,000
Per each 5 Health Plans $1,000
Manual Data Entry Fee $50 per hour
Annual Minimum Service Fee Total $5,000
Data Conversion Fee $50 per hour
Fees will be invoiced pursuant to section 4 of the Agreement.