HomeMy WebLinkAboutHR14-327 - Extension - VSP - Group Vision Care Plan Number 12229020 - 01/01/2018ApprovalOriginator:Department:
Date Sent:Date Required:
Authorized to Sign:
Director or Designee Mayor
Date of Council Approval:
Grant? Yes 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? Yes No*
Business License Verification: Yes In-Process Exempt (KCC 5.01.045)
If meets requirements per KCC 3.70.100, please complete “Vendor Purchase-Local Exceptions” form on Cityspace.
Notice required prior to disclosure?
Yes 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
Budget Account Number:
Budget? Yes No
Dir Asst:
Sup/Mgr:
Dir/Dep:
rev. 200821
FOR CITY OF KENT OFFICIAL USE ONLY
(Optional)
* Memo to Mayor must be attached
to sg
OK to sign, 3/19/2020, TW
PLEASE ATTACH TO YOUR
VISION SERVICE PLAN DOCUMENT
AMENDMENT TO YOUR POLICY PERIOD
To be attached to and made part of Vision Care Policy Number 12229020, issued to City of Kent.
EXCEPT as specifically amended herein, said Policy shall remain in full force and effect.
IT IS HEREBY AGREED that effective January 1, 2018, the Policy Period shall be changed to SIXTY months.
VSP/AMENDTERM.DOC
Accepted by:
CITY OF KENT
By:__________________________
Dana Ralph, Mayor Date
03/22/2021