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HomeMy WebLinkAboutCORRESPONDENCE - AGREEMENT MISC - INNOVUInnovu Customer Confirmation Order Form © 2016, Innovu, LLC. All Right Reserved. Page 1 of 1 Customer & Advisor Information Customer: City of Fort Collins Tax Exempt: Yes EIN #: 84-600587 Advisor: Hub International - Denver Customer Contact Lynn Sanchez Advisor Billing Contact: Nathan Wolfe Customer Phone 970.416.2098 Fax Number: Advisor Phone Fax Number: Customer Email lysanchez@fcgov.com Advisor Email: nathan.wolfe@hubinternational.com Customer Address 215 North Mason Street Advisor Billing Address Fort Collins, CO 80524 Innovu Contact: Mike Bauer Innovu BD: Opportunity ID: Solutions to be Delivered Subscription Term: 12/27/2016 TO 09/30/2017 Solution Part # Solution Name Fee Metric Qty 1 H02HLP07 HubLensPlus for 1,500 - 1,999 employees Benefit Eligible Employees 1 2 3 4 Services to be Performed Estimated Project Start Date: N/A Estimated Project Completion Date: N/A Service Part # Service/resource Name Qty or Hours 1 2 3 4 Signature Unless executed by the parties set forth below by 12/27/2016, this Innovu Order From will not be valid or binding on any party. IN WITNESS WHEREOF, the undersigned have executed this Innovu Order From by and through their respective duly authorized representatives. Innovu, LLC Customer: By: By: Name: Name: Title: Title: Date: Date: This Order Form shall be effective as of the last date of signature. This Order Form shall be governed by the Master Agreement and any applicable addenda entered into between Innovu and Customer. DocuSign Envelope ID: ED47D724-A674-4501-B38C-EA85B54DF192 Michael Bauer Chief Oerating Officer 12/27/2016 Gerry Paul Director of Purchasing 12/27/2016